Statin adherence and LDL cholesterol levels. Should we assess adherence prior to statin upgrade?

European Journal of Internal Medicine
A VodonosV Novack

Abstract

Adherence to statin therapy has been shown to be suboptimal. In statin-treated patients with residual elevated low density lipoprotein cholesterol (LDL-C) levels the physician must decide whether to switch to a more potent statin or try and achieve better adherence. We examined the association between adherence and LDL-C within low, moderate and high intensity statin groups in a "real world" setting. We assessed annual adherence by the mean MPR (Medication Possession Ratio = number of purchased/prescribed daily doses) in unselected patient group. Statins were stratified (ACC/AHA Guideline) into low, moderate and high intensity groups. The impact of adherence on LDL levels was assessed by LOESS (locally weighted scatter plot smoothing). Out of 1183 patients 173 (14.6%) were treated with low, 923 (78.0%) with moderate and 87 (7.4%) with high intensity statins. Statin intensity was inversely associated with adherence (MPR 77±21, 73±22 and 69±21% for low, moderate and high intensity respectively, p=0.018). Non-adjusted LDL levels decreased with higher adherence: a 10% adherence increase resulted in LDL decrease of 3.5, 5.8 and 7.1mg/dL in low, moderate and high intensity groups. Analysis of the adherence effect on LDL levels adjust...Continue Reading

References

Jan 1, 1997·Journal of Clinical Epidemiology·J F Steiner, A V Prochazka
Mar 27, 2002·Circulation·Christopher HeeschenUNKNOWN Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators
Dec 31, 2002·The American Journal of Medicine·Joseph P FrolkisDennis L Sprecher
Sep 27, 2006·Archives of Internal Medicine·P Michael HoDavid J Magid
Feb 27, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Kiranbir JosanFinlay A McAlister
Jun 17, 2008·Cardiovascular Drugs and Therapy·Fergus McTaggart, Peter Jones
Oct 4, 2008·The New England Journal of Medicine·Daniel Steinberg
Jun 17, 2009·European Journal of Clinical Pharmacology·Sylvie PerreaultDanielle Pilon
Oct 20, 2010·Vascular Health and Risk Management·Joel A Lardizabal, Prakash C Deedwania
Jun 30, 2011·European Heart Journal·UNKNOWN European Association for Cardiovascular Prevention & RehabilitationUNKNOWN ESC Committee for Practice Guidelines (CPG) 2008-2010 and 2010-2012 Committees

❮ Previous
Next ❯

Citations

Jun 24, 2015·Clinical Cardiology·Rajeshwari S PunekarPeter P Toth
Nov 4, 2016·Pharmacogenomics·Kavisha SinghDeepak Voora
Jan 12, 2017·Current Medical Research and Opinion·Sohan DeshpandeRoss J Simpson
Jan 24, 2018·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Richard Ofori-AsensoSophia Zoungas
Sep 5, 2019·Journal of Personalized Medicine·Danielle JohnsonAndrea Jorgensen
Dec 31, 2019·European Heart Journal. Cardiovascular Pharmacotherapy·Jörn F DopheideHeinz Drexel
Oct 2, 2019·International Journal of Clinical Practice·Michael G KirbyDerek J Rosario
May 1, 2020·British Journal of Clinical Pharmacology·Renata Cristina Rezende Macedo do NascimentoAmanj Kurdi

❮ Previous
Next ❯

Related Concepts

Related Feeds

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.