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Obese, former smokers more likely to follow statin therapy recommendations
Certain lifestyle factors may help predict adherence to recommended statin therapy for high cholesterol, according to a new report.
Specifically, adults with CV comorbidities and heavy drinkers were less likely to adhere to statin therapy, whereas those without CV comorbidities who were overweight, obese or former smokers were more likely to adhere to treatment.
Researchers evaluated 9,285 adults enrolled in the Finnish Public Sector Study, 6,458 of whom had no CV-related comorbidities. All participants initiated statin therapy from 1998 to 2010, after completing at least one survey as part of the Sector Study. Patient nonadherence within 1 year, defined as less than 80% adherence across the days covered by filled prescriptions according to dispensing data, was assessed, with available follow-up data through 2011.
Evaluated lifestyle risks included elevated BMI, tobacco use, alcohol consumption and physical activity level. Of the participants without CV comorbidities, 17.1% were obese, 16.8% were current smokers, 8.8% reported high alcohol consumption (16 drinks/week among women, 24 drinks/week among men), 5.9% reported extreme drinking episodes that consisted of passing out due to alcohol consumption at least once in the previous year and 29.8% reported low physical activity. Of the participants with CV comorbidities, 31.1% were obese, 18.2% were current smokers, 8.9% reported high alcohol consumption, 8% reported extreme drinking episodes and 35.3% reported low physical activity.
Of participants without CV comorbidities, 49.1% were nonadherent to statin therapy compared with 40.9% of patients with CV comorbidities. Obesity (OR=0.86; 95% CI, 0.74-0.99), overweight (OR=0.88; 95% CI, 0.79-0.98) and former smoking (OR=0.82; 95% CI, 0.74-0.92) were predictive of treatment adherence among patients without comorbidities. Factors associated with nonadherence among those with CV comorbidities included high alcohol consumption (OR=1.55; 95% CI, 1.12-2.15), extreme drinking episodes (OR=1.48; 95% CI, 1.11-1.97) and the presence of three to four of the evaluated lifestyle risks (OR=1.61; 95% CI, 1.15-2.27).
“The association between lifestyle factors and nonadherence to statin therapy varied according to CV morbidity status,” the researchers concluded. “… Among those without CV morbidities, information on lifestyle factors was unhelpful in identifying individuals at increased risk of nonadherence. However, the observation that overweight, obesity and former smoking were predictors of better adherence in this group provides insight into mechanisms of adherence to preventive medication that deserve further study.”
Disclosure: The researchers report no relevant financial disclosures.