Incidence of statin use in older adults with and without cardiovascular disease and diabetes mellitus, January 2008- March 2018
Autor: | Barbara L. Wells, Beth Syat, Lesley H. Curtis, Kevin Haynes, Lawrence Fine, Catherine A. Panozzo, Richard Platt, Jeffrey S. Brown, Adrian F. Hernandez, James Marshall, Pamala A. Pawloski, Sarah Malek |
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Rok vydání: | 2019 |
Předmět: |
Male
Physiology Social Sciences 030204 cardiovascular system & hematology Cardiovascular Medicine law.invention Cohort Studies 0302 clinical medicine Endocrinology Elderly Randomized controlled trial law Medicine and Health Sciences 030212 general & internal medicine Aged 80 and over Multidisciplinary Incidence (epidemiology) Drugs 3. Good health Body Fluids Blood Cardiovascular Diseases Cohort Medicine Female Anatomy Network Analysis Cohort study Research Article medicine.medical_specialty Computer and Information Sciences Statin medicine.drug_class Endocrine Disorders Science Political Science Public Policy Medicare 03 medical and health sciences Internal medicine medicine Diabetes Mellitus Humans cardiovascular diseases Aged Pharmacology business.industry Statins Biology and Life Sciences medicine.disease Comorbidity Drug Utilization Clinical trial Diabetes Mellitus Type 2 Age Groups Metabolic Disorders People and Places Observational study Population Groupings Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
Zdroj: | PLoS ONE PLoS ONE, Vol 14, Iss 12, p e0223515 (2019) |
ISSN: | 1932-6203 |
Popis: | BackgroundData from randomized controlled trials and observational studies on older adults who take statins for primary prevention of atherosclerotic cardiovascular disease are limited. To determine the incidence of statin use in older adults with and without cardiovascular disease (CVD) and/or diabetes (DM), we conducted a descriptive observational study.MethodsThe cohort consisted of health plan members in the NIH Collaboratory Distributed Research Network aged >75 years who had continuous drug and medical benefits for ≥183 days during the study period, January 1, 2008- March 31, 2018. We defined DM and CVD using diagnosis codes, and identified statins using dispensing data. Statin use was considered incident if a member had no evidence of statin exposure in the claims during the previous 183 days, and the use was considered long-term if statins were supplied for ≥180 days. Incidence rates were reported among members with and without CVD and/or diabetes, and stratified by year, sex, and age group.ResultsAmong 757,569 eligible members, 109,306 older adults initiated statins and 54,624 became long-term users. Health plan members with CVD had the highest incidence of statin use (143.9 initiators per 1,000 member-years for CVD & DM; 114.5 initiators per 1,000 member-years for CVD & No DM). Among health plan members without CVD, those with DM had rates of statin use that were over two times higher than members without DM (76.1 versus 34.5 initiators per 1,000 member-years, respectively). Statin initiation remained steady throughout 2008-2016, was slightly higher in males, and declined with increasing age.ConclusionIncidence of statin use varied by CVD and DM comorbidity, and was lowest among those without CVD. These results highlight the potential clinical equipoise to conduct large pragmatic clinical trials to generate evidence that could be used to inform future blood cholesterol guidelines. |
Databáze: | OpenAIRE |
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