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Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke.

Abstract：

BACKGROUND:Poor adherence to medication regimens is common, potentially contributing to the occurrence of related disease. OBJECTIVES:The authors sought to assess the risk of fatal stroke associated with nonadherence to statin and/or antihypertensive therapy. METHODS:We conducted a population-based study using electronic medical and prescription records from Finnish national registers in 1995 to 2007. Of the 58,266 hypercholesterolemia patients age 30+ years without pre-existing stroke or cardiovascular disease, 532 patients died of stroke (cases), and 57,734 remained free of incident stroke (controls) during the mean follow-up of 5.5 years. We captured year-by-year adherence to statin and antihypertensive therapy in both study groups and estimated the excess risk of stroke death associated with nonadherence. RESULTS:In all hypercholesterolemia patients, the adjusted odds ratio for stroke death for nonadherent compared with adherent statin users was 1.35 (95% confidence interval [CI] 1.04 to 1.74) 4 years before and 2.04 (95% CI: 1.72 to 2.43) at the year of stroke death or the end of the follow-up. In hypercholesterolemia patients with hypertension, relative to those who adhered to statins and antihypertensive therapy, the odds ratio at the year of stroke death was 7.43 (95% CI: 5.22 to 10.59) for those nonadherent both to statin and antihypertensive therapy, 1.82 (95% CI: 1.43 to 2.33) for those non-adherent to statin but adherent to antihypertensive therapy, and 1.30 (95% CI: 0.53 to 3.20) for those adherent to statin, but nonadherent to antihypertensive, therapy. CONCLUSIONS:Individuals with hypercholesterolemia and hypertension who fail to take their prescribed statin and antihypertensive medication experience a substantially increased risk of fatal stroke. The risk is lower if the patient is adherent to either one of these therapies.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Herttua K,Martikainen P,Batty GD,Kivimäki M

doi

10.1016/j.jacc.2016.01.044

subject

Has Abstract

pub_date

2016-04-05 00:00:00

pages

1507-1515

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(16)00404-6

journal_volume

pub_type

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Poor Adherence to Statin and Antihypertensive Therapies as Risk Factors for Fatal Stroke.