Related Experiment Video
Updated: Mar 6, 2026

Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Insurance, self-reported medication adherence and LDL cholesterol: The REasons for Geographic And Racial Differences
Matt Mefford1, Monika M Safford2, Paul Muntner1
1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Background:
Lack of health insurance may adversely impact medication adherence and the control of cardiovascular risk factors. We examined if the association between insurance and LDL-C is due to self-reported low medication adherence.
Methods:
This cross-sectional study included 8685 black and white men and women aged 45 and older who participated in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort and used statins. Medication adherence was assessed using the 4-item Morisky Medication Adherence Scale (MMAS-4). Mean differences in LDL-C between participants with and without insurance were calculated using generalized linear models before and after adjustment for MMAS-4. Subgroups stratified by age, annual household income, diabetes, and CHD were compared. Separately, individual MMAS-4 questions were examined for mediation effects.
Results:
After multivariable adjustment but without MMAS-4, LDL-C was 2.5mg/dL (95% CI -0.6, 5.6) higher among uninsured versus insured participants. After further adjustment for MMAS-4, LDL-C was 2.6mg/dL (95% CI -0.5, 5.6) higher. Stratified analyses produced similar results. No mediating effect was observed when each MMAS-4 question was examined separately.
Conclusion:
High medication adherence does not mediate the association between having health insurance and lower LDL-C.
Related Concept Videos
Atherosclerosis III: Management
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
Coronary Artery Disease IV: Preventive Measures
Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Atherosclerosis IV: Nursing Management
Cholesterol: Significance and Regulation
Considering cholesterol and...