![]() Therefore, using data from a national cohort of patients with CVD, we aimed to determine whether the use of high-intensity statin therapy is associated with a lower adherence to statin medications compared with low- to moderate-intensity statin therapy. This has implications as health care providers adopt the recent cholesterol guideline 1 into clinical practice. Although it is possible that a higher risk of side effects from high-intensity statin therapy could affect medication adherence compared with low-intensity statin therapy, this issue has not been well explored in the literature. Evaluation of safety data indicates that high-intensity statin therapy is also accompanied by increased side effects and adverse events, posing a risk to adherence in CVD patients treated with high-intensity statins. 1 This is based on studies showing that statin therapy, 2- 4 and more important, high-intensity statin therapy, 5- 7 is associated with an improvement in cardiovascular outcomes compared with low-intensity statin therapy.Īlthough a number of studies have compared high-intensity statins with low- or moderate-intensity statins, 5- 7 most have focused on evaluating the effectiveness of these therapies in reducing CVD events and improving prognosis. The 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guideline on treatment of blood cholesterol recommends high-intensity statin use in most patients with cardiovascular disease (CVD). However, this change may be associated with a very modest reduction in statin adherence compared with low- to moderate-intensity therapy that is unlikely to be of clinical significance. ConclusionsĪn approach of high-intensity statin therapy will lead to a significant practice change, as the majority of CVD patients are not on high-intensity therapy. In adjusted analyses, high-intensity statin use was associated with a significant but modest PDC reduction compared with low- to moderate-intensity statin use, whether PDC was assessed as a continuous (β-coefficient: −0.008, P < 0.0001) or categorical (PDC ≥0.80 ) measure of statin adherence. Mean PDC (0.87 vs 0.86, P < 0.0001) and patients with PDC ≥0.80 (76.3% vs 74.2%, P < 0.0001) were slightly higher for those receiving low- to moderate-intensity compared with high-intensity statins. Of those, 229 437 (36.5%) received high-intensity statins. We assessed statin adherence by calculating proportion of days covered (PDC) and determined whether high-intensity statin therapy was independently associated with a lower PDC. In a national database of 972 532 CVD patients from the Veterans Health Administration, we identified patients receiving statins between October 1, 2010, and September 30, 2011. High-intensity statins are associated with lower adherence compared with low- to moderate-intensity statins. Therefore, it may be of concern that these recommendations might reduce statin adherence. High-intensity statins are associated with more frequent side effects. Statins: actions, side effects, and administration.The recent cholesterol guideline recommends high-intensity statins in cardiovascular disease (CVD) patients. FDA drug safety communication: important safety label changes to cholesterol-lowering statin drugs. Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. doi:10.1186/s12937-0Ĭulver AL, Ockene IS, Balasubramanian R, et al. Time-varying and dose-dependent effect of long-term statin use on risk of type 2 diabetes: a retrospective cohort study. Diabetes/Metabolism Research and Reviews. Statin users have an elevated risk of dysglycemia and new-onset-diabetes. Understanding your risks to prevent a heart attack. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2022. ACC/AHA lipid guidelines: Personalized care to prevent cardiovascular disease. Reiter-Brennan C, Osei AD, Iftekhar Uddin SM, Orimoloye OA, Obisesan OH, Mirbolouk M, Blaha MJ, Dzaye O. Cholesterol medications.Ĭenters for Disease Control and Prevention. Classification and diagnosis of diabetes: Standards of medical care in diabetes-2022. Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents. Cholesterol and diabetes.ĭi Pino A, DeFronzo RA.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |