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Are high-risk hypertensive patients being prescribed concomitant statin therapy?: a retrospective cohort study

Richard H Chapman1, Allison A Petrilla, Lance Berman

  • 1US Health Economics and Outcomes Research, IMS Health, Falls Church, Virginia 22046, USA. RChapman@us.imshealth.com

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
|October 2, 2009
PubMed

Insights

Many patients starting blood pressure medication do not receive statin therapy, even with high cardiovascular disease risk. Increased statin use could benefit hypertensive patients with additional risk factors.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Public Health

Background:

  • Current dyslipidemia treatment guidelines prioritize lipid levels and risk assessment.
  • Normolipidemic individuals with multiple cardiovascular disease (CVD) risk factors may benefit from HMG-CoA reductase inhibitor (statin) therapy.

Purpose of the Study:

  • To investigate the frequency of statin prescriptions among patients initiating antihypertensive drug treatment in a US managed-care setting.
  • To identify factors associated with receiving concurrent statin therapy in this population.

Main Methods:

  • Retrospective cohort study utilizing the PharMetrics' Patient-Centric Database.
  • Inclusion of patients initiating antihypertensive treatment between September 2001 and February 2004 with varying coronary heart disease (CHD) risk levels.
  • Analysis of cumulative probability of statin therapy and multivariable logistic regression to determine predictors of statin use.

Main Results:

  • Out of 142,389 patients initiating antihypertensives, 22.5% received statins within one year.
  • Statin prescription probability increased with the number of CHD risk factors, regardless of dyslipidemia status.
  • Patients with dyslipidemia (AOR 5.68), established CHD/congestive heart failure (AOR 3.39), or multiple risk factors without CHD (AOR 3.01) were more likely to receive statins.

Conclusions:

  • Hypertensive patients with established CHD or significant risk factors were more likely to receive statins, yet many did not fill prescriptions.
  • A considerable number of hypertensive patients with additional CHD risk factors could potentially benefit from increased statin therapy utilization.
Abstract

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