- As statin therapy adherence declines, mortality risk climbs in people who have atherosclerotic cardiovascular disease (ASCVD).
- Specific groups show increased risk for poor adherence, including women, minorities, and the age extremes.
Why this matters
- The reasons people do not adhere to statins are complex, so different solution options are needed.
- Editorial: results are a reminder that adherence is a key factor in the success of this therapy; without it, “the full benefit of this investment will never be realized.”
- Those on moderate-intensity therapy had better adherence vs high-intensity:
- OR, 1.18 (95% CI, 1.16-1.20).
- Mean adherence was 87.7%.
- Vs highest adherence (≥90%), adjusted mortality HRs (95% CIs) were:
- 50%-69% score: 1.21 (1.18-1.24).
- 70%-89%: 1.08 (1.06-1.09).
- Less adherence was also tied to more stroke, ischemic heart disease hospitalizations.
- Less adherence was seen among women, minorities, and in the age extremes (adults 74 years).
- Retrospective cohort study of 347,104 people, ages 21-85 years, treated in the US Veterans Affairs (VA) system.
- Adherence: defined by medication possession ratio (%, higher=better).
- Primary outcome was all-cause mortality.
- Funding: VA.
- Residual confounding possible; causation not established.