Statin Underuse and Low Prevalence of LDL-C Control Among U.S. Adults at High Risk of Coronary Heart Disease
| Autor: | Monika M. Safford, Devin M. Mann, Rosenson Robert, Michael E. Farkouh, Christopher Gamboa, Stephen P. Glasser, Huifeng Yun, Emily B. Levitan, Paul Muntner, J. Michael Woolley |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Statin medicine.drug_class Coronary Disease Article Risk Factors Diabetes mellitus Internal medicine Epidemiology Prevalence medicine Humans cardiovascular diseases Risk factor Stroke Aged Framingham Risk Score business.industry Cholesterol LDL General Medicine Models Theoretical medicine.disease United States Confidence interval Cardiology Female Hydroxymethylglutaryl-CoA Reductase Inhibitors business Risk assessment |
| Zdroj: | The American Journal of the Medical Sciences. 348:108-114 |
| ISSN: | 0002-9629 |
| Popis: | Statins reduce the risk of coronary heart disease (CHD) in individuals with a history of CHD or risk equivalents. A 10-year CHD risk20% is considered a risk equivalent but is frequently not detected. Statin use and low-density lipoprotein cholesterol (LDL-C) control were examined among participants with CHD or risk equivalents in the nationwide Reasons for Geographic and Racial Differences in Stroke study (n = 8812).Participants were categorized into 4 mutually exclusive groups: (1) history of CHD (n = 4025); (2) no history of CHD but with a history of stroke and/or abdominal aortic aneurysm (AAA) (n = 946); (3) no history of CHD or stroke/AAA but with diabetes mellitus (n = 3134); or (4) no history of the conditions in (1) through (3) but with 10-year Framingham CHD risk score (FRS)20% calculated using the third Adult Treatment Panel point scoring system (n = 707).Statins were used by 58.4% of those in the CHD group and 41.7%, 40.4% and 20.1% of those in the stroke/AAA, diabetes mellitus and FRS20% groups, respectively. Among those taking statins, 65.1% had LDL-C100 mg/dL, with no difference between the CHD, stroke/AAA, or diabetes mellitus groups. However, compared with those in the CHD group, LDL-C100 mg/dL was less common among participants in the FRS20% group (multivariable adjusted prevalence ratio: 0.72; 95% confidence interval: 0.62-0.85). Results were similar using the 2013 American College of Cardiology/American Heart Association cholesterol treatment guideline.These data suggest that many people with high CHD risk, especially those with an FRS20%, do not receive guideline-concordant lipid-lowering therapy and do not achieve an LDL-C100 mg/dL. |
| Databáze: | OpenAIRE |
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