The percentage of adults who have had a heart attack or have diabetes and regularly take statins — a medication used to lower cholesterol and reduce the risk for future cardiovascular events — has increased modestly in the United States. However, the percentage of adults who take statins regularly without a history of heart attack or diabetes has remained the same.
A study published in the Journal of the American Heart Association found that, while several interventions to improve the use of cholesterol-lowering medications have been implemented in the last decade, the percentage of adults taking statins regularly still remains low. The study conducted by researchers from the University of Alabama at Birmingham investigated more than 3 million adults from across the United States, using data recorded between 2007 and 2014.
“We found that, in 2014, only 60 percent of patients with a heart attack and less than 40 percent of those without a history of heart attack took their statin medication regularly or ‘with high adherence,’” said Lisandro Colantonio, M.D., Ph.D., a researcher at the UAB School of Public Health and lead study author. “When we analyzed the percentage of patients who took their statin even if irregularly but did not discontinue, we found no changes between 2007 and 2014.”
The study highlights the need to improve adherence to statin therapy.
“Statin therapy is one of the most effective interventions to reduce the risk for heart attack and stroke,” Colantonio explained. “Results from our study highlight the need to increase awareness about the importance of taking statin therapy regularly to reduce the risk for heart attacks and stroke.”
According to researchers, patients who do not take their statin medication regularly may still have a high risk for a future heart attack or stroke. Physicians and health care providers can help their patients to take statin therapy regularly.
“There are many reasons patients may not take their statin regularly, including concerns about side effects, cost or perceived lack of need,” Colantonio said. “Therefore, it is important that health care providers ask their patients about their statin use and work with them to identify reasons for not taking this medication with high adherence.”
Deeper dive
The researchers also investigated the characteristics of patients who take statins with high adherence. The characteristics identified in the study may help health care providers to recognize those patients who are more likely to not take their statin medication with regularity.
“We found that men and patients with a history of stroke, those who take antihypertensive medication on a regular basis, and those who receive cardiologist care are more likely to take their statin regularly,” Colantonio explained. “On the other hand, younger patients, African-Americans and Hispanics were less likely to take their statin regularly.”
Colantonio adds that health care providers may have more frequent visits with patients who are more likely to not take their statin therapy with high adherence to assess their medication use.
As for why there was an improvement in the percentage of patients with a history of heart attack or diabetes taking statin therapy regularly between 2007 and 2014, researchers say fear of future medical events may be a driving motivation.
“These patients may be more motivated to take statin therapy regularly as compared with those without diabetes or a heart attack because they know they have a high risk for a future heart attack or stroke,” Colantonio said. “Although the increase in adherence to statin therapy in patients with a heart attack or diabetes found in our study is encouraging, there is still a need for more improvements to prevent future heart attacks and strokes.”
The study was published in the Journal of the American Heart Association. Paul Muntner, Ph.D., epidemiologist and associate dean for Research at the UAB School of Public Health, and Luqin Deng and Yuling Dai, statisticians at UAB, also contributed to the study.