Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:26-32 - Vol. 71 Num.01 DOI: 10.1016/j.rec.2017.04.002

Persistence With Statins in Primary Prevention of Cardiovascular Disease: Findings From a Cohort of Spanish Workers

Sara Malo a,, Isabel Aguilar-Palacio a, Cristina Feja a, Enrica Menditto b, María Jesús Lallana c, Elena Andrade d, José Antonio Casasnovas e, María José Rabanaque a

a Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
b Centro Interdipartimentale di Ricerca in Farmacoeconomia e Farmacoutilizzazione (CIRFF), Università degli Studi di Napoli Federico II, Napoli, Italy
c Servicio Aragonés de Salud, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
d Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Madrid/IdiPaz y CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
e Departamento de Medicina, Psiquiatría y Dermatología, Universidad de Zaragoza, Fundación Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain

Refers to

Keywords

Discontinuation. Lipid-lowering drug. Pharmacoepidemiology. Medication. Measurement. Cardiovascular disease. Primary prevention.

Abstract

Introduction and objectives

The aim of this study was to assess patterns of treatment persistence in a cohort of male Spanish workers receiving statin therapy for primary prevention of cardiovascular disease.

Methods

This descriptive study was conducted within the framework of the prospective longitudinal Aragon Workers’ Health Study (N = 5400). Incident male statin users were identified based on data collected from the regional government's medication consumption information system. Patterns of treatment persistence with statins prescribed for primary cardiovascular disease prevention were assessed and the relevance of potential predictors explored.

Results

Among the 725 new statin users, less than one third remained persistent during the 1 year of follow-up. About 15% of nonpersistent users discontinued statin therapy after dispensation of the first prescription; of these, 42.1% did not recommence treatment within the following year. Factors reducing the likelihood of treatment discontinuation were older age (HR, 0.55; 95%CI, 0.39-0.77) and cotreatment with antihypertensive drugs (HR, 0.68; 95%CI, 0.56-0.82). No association was observed between treatment persistence and cotreatment with antidiabetic or antithrombotic drugs, baseline low-density lipoprotein levels, or total cholesterol levels. However, persistence was influenced by the type of statin first prescribed.

Conclusions

Our analysis of a cohort of healthy male workers revealed poor statin persistence. These findings underscore the need for a better understanding of patterns of statin use, especially in apparently healthy individuals, and for the incorporation of patient behavior into prescribing decisions.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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