Incidence of statin use in older adults with and without cardiovascular disease and diabetes mellitus, January 2008- March 2018.

Published online

Journal Article

BACKGROUND: Data from randomized controlled trials and observational studies on older adults who take statins for primary prevention of atherosclerotic cardiovascular disease are limited. To determine the incidence of statin use in older adults with and without cardiovascular disease (CVD) and/or diabetes (DM), we conducted a descriptive observational study. METHODS: The cohort consisted of health plan members in the NIH Collaboratory Distributed Research Network aged >75 years who had continuous drug and medical benefits for ≥183 days during the study period, January 1, 2008- March 31, 2018. We defined DM and CVD using diagnosis codes, and identified statins using dispensing data. Statin use was considered incident if a member had no evidence of statin exposure in the claims during the previous 183 days, and the use was considered long-term if statins were supplied for ≥180 days. Incidence rates were reported among members with and without CVD and/or diabetes, and stratified by year, sex, and age group. RESULTS: Among 757,569 eligible members, 109,306 older adults initiated statins and 54,624 became long-term users. Health plan members with CVD had the highest incidence of statin use (143.9 initiators per 1,000 member-years for CVD & DM; 114.5 initiators per 1,000 member-years for CVD & No DM). Among health plan members without CVD, those with DM had rates of statin use that were over two times higher than members without DM (76.1 versus 34.5 initiators per 1,000 member-years, respectively). Statin initiation remained steady throughout 2008-2016, was slightly higher in males, and declined with increasing age. CONCLUSION: Incidence of statin use varied by CVD and DM comorbidity, and was lowest among those without CVD. These results highlight the potential clinical equipoise to conduct large pragmatic clinical trials to generate evidence that could be used to inform future blood cholesterol guidelines.

Full Text

Duke Authors

Cited Authors

  • Panozzo, CA; Curtis, LH; Marshall, J; Fine, L; Wells, BL; Brown, JS; Haynes, K; Pawloski, PA; Hernandez, AF; Malek, S; Syat, B; Platt, R

Published Date

  • 2019

Published In

Volume / Issue

  • 14 / 12

Start / End Page

  • e0223515 -

PubMed ID

  • 31805056

Pubmed Central ID

  • 31805056

Electronic International Standard Serial Number (EISSN)

  • 1932-6203

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0223515

Language

  • eng

Conference Location

  • United States