Initiation of lipid-lowering therapy as primary prevention of cardiovascular disease in the elderly
Metadatos
Mostrar el registro completo del ítemAutor
Vinuesa Hernando, José Manuel; Aguilar Palacio, Isabel; Rabanaque, María José; Garcia-Cardenas, Victoria; Lallana, María Jesús; Gamba, Adriana; Malo, SaraEditorial
British Pharmacological Society
Materia
aged, cardiovascular primary prevention hypolipidaemic agents
Fecha
2024-07-03Referencia bibliográfica
Vinuesa Hernando, J.M. et. al. Br J Clin Pharmacol. 2024;1‐10. [https://doi.org/10.1111/bcp.16157]
Patrocinador
Biocomputing Unit at the Aragon Health Sciences Institute (IACS) for support in accessing the data, available through BIGAN (Orden SAN/1355/2018).Resumen
Aims: This study aimed to analyse the initiation adherence phase to lipid-lowering
therapy for primary prevention of cardiovascular disease in a Spanish population
aged 70 years or older. The secondary objective was to identify the determinants of
initiation and early discontinuation.
Methods: This was an observational study conducted in the CArdiovascular Risk factors
for HEalth Service research (CARhES) cohort. People aged 70 and older with a
first prescription of a lipid-lowering drug and without a previous major adverse cardiovascular
event (MACE) were selected (2018–2021). Data on sociodemographics,
clinical conditions, drugs and use of health services were collected from clinical and
administrative electronic databases. The study population was classified into: noninitiation,
early discontinuation (i.e., discontinuation after the first dispensing) and initiation
with more than one dispensing. Their characteristics were compared. Determinants
of initiation and early discontinuation were explored.
Results: Among the 15 019 people studied, 80.2% initiated the medication, 11.2%
showed an early discontinuation and 8.6% were non-initiators. An older age or conditions
such as dementia, diabetes or depression reduced the likelihood of initiation,
while obesity and a high pharmacological burden increased it. People over 90 years
of age or those prescribed a statin in combination were more likely to have an early
discontinuation.
Conclusions: Non-initiation and early discontinuation are common among older people
prescribed lipid-lowering drugs as primary prevention of cardiovascular disease
for the first time. The presence of chronic pathologies other than cardiovascular ones
should be considered when assessing whether or not to prescribe these drugs in the
elderly.