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Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency.

Publication ,  Journal Article
Solomon, R; Anne, P; Swisher, J; Nazeer, B; Rosman, H; Mehta, RH; Maciejko, JJ
Published in: High Blood Press Cardiovasc Prev
September 2022

INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) is the major cause of morbidity and mortality worldwide. Statins provide primary and secondary ASCVD prevention. Intolerance due to statin-associated myalgias reduces long-term adherence, thus muting potential benefits. AIM: Our analysis sought to determine whether transition from a lipophilic statin to a water-soluble statin, or correction of subclinical hypothyroidism and/or vitamin D insufficiency/deficiency (metabolic abnormalities), improved statin tolerance. METHODS: We performed a retrospective analysis of the data from patients referred to our lipid clinic because of statin intolerance. Patients intolerant to a lipophilic statin were switched to a water-soluble statin. Patients having vitamin D insufficiency/deficiency or subclinical hypothyroidism were re-challenged with a water-soluble statin (or lipophilic statin with minimal systemic exposure) after correction of the metabolic abnormality. RESULTS: 169 patients were statin intolerant. 86% (n = 145) were white and 48% (n = 81) were male. 82 of these patients had one or both metabolic abnormalities. The remaining patients (n = 87) had no metabolic abnormality, however, were unable to tolerate a lipophilic statin. 72% (n = 73) of eligible patients (n = 101), defined as those with a corrected metabolic abnormality or without a metabolic abnormality on a lipophilic statin, were able to tolerate a water-soluble statin or lipophilic statin with minimal systemic exposure. In addition, 75% (n = 127) of this total cohort met their LDL-C goal. CONCLUSIONS: Our findings suggest that either correction of subclinical hypothyroidism and/or vitamin D insufficiency/deficiency or transition from a lipophilic statin to water-soluble statin (or lipophilic statin with minimal systemic exposure) improves statin tolerance.

Duke Scholars

Published In

High Blood Press Cardiovasc Prev

DOI

EISSN

1179-1985

Publication Date

September 2022

Volume

29

Issue

5

Start / End Page

409 / 415

Location

New Zealand

Related Subject Headings

  • Water
  • Vitamins
  • Vitamin D Deficiency
  • Vitamin D
  • Retrospective Studies
  • Male
  • Hypothyroidism
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Solomon, R., Anne, P., Swisher, J., Nazeer, B., Rosman, H., Mehta, R. H., & Maciejko, J. J. (2022). Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency. High Blood Press Cardiovasc Prev, 29(5), 409–415. https://doi.org/10.1007/s40292-022-00537-2
Solomon, Robert, Premchand Anne, Jordan Swisher, Beshoy Nazeer, Howard Rosman, Rajendra H. Mehta, and James J. Maciejko. “Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency.High Blood Press Cardiovasc Prev 29, no. 5 (September 2022): 409–15. https://doi.org/10.1007/s40292-022-00537-2.
Solomon R, Anne P, Swisher J, Nazeer B, Rosman H, Mehta RH, et al. Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency. High Blood Press Cardiovasc Prev. 2022 Sep;29(5):409–15.
Solomon, Robert, et al. “Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency.High Blood Press Cardiovasc Prev, vol. 29, no. 5, Sept. 2022, pp. 409–15. Pubmed, doi:10.1007/s40292-022-00537-2.
Solomon R, Anne P, Swisher J, Nazeer B, Rosman H, Mehta RH, Maciejko JJ. Evaluating Statin Tolerability in Historically Intolerant Patients After Correcting for Subclinical Hypothyroidism and Vitamin D Insufficiency. High Blood Press Cardiovasc Prev. 2022 Sep;29(5):409–415.
Journal cover image

Published In

High Blood Press Cardiovasc Prev

DOI

EISSN

1179-1985

Publication Date

September 2022

Volume

29

Issue

5

Start / End Page

409 / 415

Location

New Zealand

Related Subject Headings

  • Water
  • Vitamins
  • Vitamin D Deficiency
  • Vitamin D
  • Retrospective Studies
  • Male
  • Hypothyroidism
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female