+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Ability of low antihypertensive medication adherence to predict statin discontinuation and low statin adherence in patients initiating treatment after a coronary event



Ability of low antihypertensive medication adherence to predict statin discontinuation and low statin adherence in patients initiating treatment after a coronary event



American Journal of Cardiology 114(6): 826-831



Low statin adherence and discontinuation of statins are common in patients with coronary heart disease. We hypothesized that low antihypertensive medication adherence would be associated with future statin discontinuation and low adherence in patients initiating statins. Using a 5% national sample of Medicare beneficiaries, we conducted a cohort study of Medicare beneficiaries initiating statins after hospitalization for acute myocardial infarction or coronary revascularization in 2007, 2008, and 2009. Antihypertensive medication adherence, defined using the average proportion of days covered across 5 classes during the 365 days before hospitalization, was categorized as ≥80% (high), 50% to <80% (medium), and <50% (low). Statin discontinuation was defined as failure to refill a statin within 365 days of hospital discharge, and low adherence was defined as proportion of days covered for statins <80%. In 2,695 Medicare beneficiaries who initiated statins after hospital discharge, 6.0%, 8.4%, and 14.5% with high, medium, and low antihypertensive medication adherence discontinued statins. After multivariable adjustment, the risk ratios (95% confidence interval) for statin discontinuation were 1.38 (0.98 to 1.95) and 2.41 (1.51 to 3.87) for beneficiaries with medium and low versus high antihypertensive medication adherence, respectively. In beneficiaries who did not discontinue statins, 36.2% had low statin adherence. Compared with high adherence, medium and low antihypertensive medication adherences were associated with multivariable adjusted risk ratios (95% confidence interval) for low statin adherence of 1.33 (1.14 to 1.55) and 1.62 (1.25 to 2.10), respectively. In conclusion, low antihypertensive medication adherence before initiating statins is associated with future statin discontinuation and low statin adherence.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 051305380

Download citation: RISBibTeXText

PMID: 25103917

DOI: 10.1016/j.amjcard.2014.06.009


Related references

Comparison of Low-Dose Statin Versus Low-Dose Statin + Armolipid Plus in High-Intensity Statin-Intolerant Patients With a Previous Coronary Event and Percutaneous Coronary Intervention (ADHERENCE Trial). American Journal of Cardiology 120(6): 893-897, 2017

Trends in Antihypertensive Medication Discontinuation and Low Adherence Among Medicare Beneficiaries Initiating Treatment From 2007 to 2012. Hypertension 68(3): 565-575, 2016

Predictors of Statin Adherence, Switching, and Discontinuation in the USAGE Survey Understanding Statin Use in America and Gaps in Patient Education. Journal of Clinical Lipidology 7(3): 245-246, 2013

The effects of reduced copayments on discontinuation and adherence failure to statin medication in Australia. Health Policy 119(5): 620-627, 2015

LDL cholesterol response and statin adherence among high-risk patients initiating treatment. American Journal of Managed Care 22(3): E106-E115, 2016

The impact of pharmacist face-to-face counseling to improve medication adherence among patients initiating statin therapy. Patient Preference and Adherence 6: 323-329, 2012

It's Not Too Late to Improve Statin Adherence: Association Between Changes in Statin Adherence from Before to After Acute Myocardial Infarction and All-Cause Mortality. Journal of the American Heart Association 8(7): E011378, 2019

Physicians' ability to predict patients' adherence to antihypertensive medication in primary care. Hypertension Research 31(9): 1765-1771, 2008

Statin adherence and LDL cholesterol levels. Should we assess adherence prior to statin upgrade?. European Journal of Internal Medicine 26(4): 268-272, 2015

Statin treatment non-adherence and discontinuation: clinical implications and potential solutions. Current Pharmaceutical Design 20(40): 6314-6324, 2014

Does a cardiovascular event change adherence to statin treatment in patients with type 2 diabetes? A matched cohort design. Current Medical Research and Opinion 31(4): 595-602, 2015

Pharmacy-based predictors of non-persistence with and non-adherence to statin treatment among patients on oral diabetes medication in the Netherlands. Current Medical Research and Opinion 34(6): 1013-1019, 2018

A Discrete Event Simulation Model to Assess the Economic Value of a Hypothetical Pharmacogenomics Test for Statin-Induced Myopathy in Patients Initiating a Statin in Secondary Cardiovascular Prevention. Molecular Diagnosis and Therapy 22(2): 241-254, 2018

Antihyperlipidemic Medication Treatment Patterns and Statin Adherence Among Patients with ASCVD in a Managed Care Plan After Release of the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol. Journal of Managed Care & Specialty Pharmacy 22(8): 892-900, 2016

Genetically guided statin therapy on statin perceptions, adherence, and cholesterol lowering: a pilot implementation study in primary care patients. Journal of Personalized Medicine 4(2): 147-162, 2014