Patients at high risk from cardiovascular disease should be prescribed high doses of statins and adherence monitored closely, according to a new observational analysis.
According to the study of UK GP records, 12,000 cardiovascular events a year could be prevented by stepping up prescribing of statins.
Researchers at Imperial College, London, and Leicester University studied patients with established cardiovascular disease – together with those with diabetes and those with chronic kidney disease.
They identified some 30,000 patients who had recently started statin treatment from the Clinical Practice Research Datalink, which includes 450 practices.
They found that patients with high adherence and high dose prescriptions enjoyed a 40% reduction in their risk of cardiovascular events.
This compared with a 5% reduction for those on low dose statins and poor adherence, according to the report in JAMA Network Open.
Researcher Professor Kausik Ray, from Imperial College, said: “In terms of risk reduction, we can see the people who do the best are those who are adhering to the recommended dosage and are on more potent drug regimens.
“But if someone is not going to take a treatment as recommended, they may actually be better off on higher doses of statins so that when they are taking the medication, they are achieving greater cholesterol reductions.”
Fellow researcher Professor Kamlesh Khunti said: “Adherence to lipid lowering therapy is poor within first six months, with studies showing that 40–60% of people are not adherent to statin therapies.
“This novel concept of a measure of adherence and intensity is likely to be applicable to other medications such as antihypertensive and glucose lowering therapies as well.”
Association of a Combined Measure of Adherence and Treatment Intensity with Cardiovascular Outcomes in Patients with Atherosclerosis or Other Cardiovascular Risk Factors Treated with Statins and/or Ezetimibe. JAMA Network Open 7 December 2018; doi: 10.1001/jamanetworkopen.2018.5554
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