Statins use for primary prevention of cardiovascular disease: A population-based digitally enabled real-world evidence cross-sectional study in primary care in Brazil.

Autor: Santo K; Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil (Santo, Santos, Nieri, Monfardini and Berwanger). Electronic address: karla.santo@einstein.br., Santos RD; Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil (Santo, Santos, Nieri, Monfardini and Berwanger); Heart Institute (InCor), University of Sao Paulo Medical School, 44 Dr Enéas Carvalho de Aguiar Avenue, Cerqueira César, São Paulo, SP, Postal Code 05403-900, Brazil (Santos)., Girotto AN; epHealth Primary Care Solutions, 3339 Dr. Antônio Luiz Moura Gonzaga Road, Room 107 Block A, Rio Tavares, Florianópolis, SC, Postal Code 88048-300, Brazil (Girotto and Pereira)., Nieri J; Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil (Santo, Santos, Nieri, Monfardini and Berwanger)., Monfardini F; Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil (Santo, Santos, Nieri, Monfardini and Berwanger)., Raupp P; Novartis Biociências Brazil, 90 Professor Vicente Rao Avenue, Cidade Monções, São Paulo, SP, Postal Code 04706-900, Brazil (Raupp)., Pereira PM; epHealth Primary Care Solutions, 3339 Dr. Antônio Luiz Moura Gonzaga Road, Room 107 Block A, Rio Tavares, Florianópolis, SC, Postal Code 88048-300, Brazil (Girotto and Pereira); epHealth UK, C/O Taylor Vinters, Floor 33 Tower 42, 25 Old Broad Street, London, EC2N 1HQ, United Kingdom (Pereira); Instituto epHealth, 2302 Consolação Street, CJ 21, Room 104, Consolação, Sao Paulo, SP, Postal Code 01302-001, Brazil (Pereira)., Berwanger O; Hospital Israelita Albert Einstein, 755 Comendador Elias Jafet Street, room 408/409, Floor L4, Morumbi, São Paulo, SP, Postal Code 05653-000, Brazil (Santo, Santos, Nieri, Monfardini and Berwanger); The George Institute for Global Health, 4 Wood Ln, London, NW9 7PA, United Kingdom (Berwanger); Imperial College London, 80 Wood Ln, London, W12 7TA, United Kingdom (Berwanger)., Machline-Carrion MJ; epHealth UK, C/O Taylor Vinters, Floor 33 Tower 42, 25 Old Broad Street, London, EC2N 1HQ, United Kingdom (Pereira); Instituto epHealth, 2302 Consolação Street, CJ 21, Room 104, Consolação, Sao Paulo, SP, Postal Code 01302-001, Brazil (Pereira).
Jazyk: angličtina
Zdroj: Journal of clinical lipidology [J Clin Lipidol] 2024 May-Jun; Vol. 18 (3), pp. e384-e393. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1016/j.jacl.2024.02.005
Abstrakt: Background: Statins are the main strategy to reduce dyslipidemia-related cardiovascular risk. Nevertheless, there is scarce evidence on the real-world statins use in primary care settings in low-middle-income countries.
Objective: We conducted a cross-sectional retrospective study using anonymized data routinely collected by community health workers in Brazil aimed to evaluate statin use and associated factors in a primary prevention population with cardiovascular risk enhancers.
Methods: Study population consisted of adults with hypertension, diabetes, and/or dyslipidemia. The primary and secondary outcomes were the proportion of individuals self-reporting statins use on any dose and high-dose statins/high-intensity lipid-lowering therapy (LLT), respectively.
Results: Of the 2,133,900 adult individuals in the database, 415,766 (19.5%) were included in the study cohort. From this cohort, 89.1% had hypertension, 28.9% diabetes, and 5.5% dyslipidemia. The mean age was 61.5 (standard deviation 14.5) years, 63.4% were female, and 61.0% were of mixed-race. Only 2.6% and 0.1% of individuals self-reported the use of statins and high-dose statins/high-intensity LLT, respectively. Older age (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.88, 2.05, p < 0.001), living in the South region of Brazil (OR 4.39; 95% CI 3.97, 4.85, p < 0.001), heart failure (OR 2.60; 95% CI 2.33, 2.89, p < 0.001), chronic kidney disease (OR 1.49; 95% CI 1.35, 1.64, p < 0.001), and anti-hypertensive medications use (OR 4.38; 95% CI 4.07, 4.71, p < 0.001) were independently associated with statin use.
Conclusion: In a real-world evidence study analyzing data routinely collected in a digitized primary care setting, we observed a very low use of statins in a primary prevention population with cardiovascular risk enhancers in Brazil. Socio-demographic factors and co-morbidities were associated with higher statins use rates.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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