Statin use in adults at high risk of cardiovascular disease mortality: cross-sectional analysis of baseline data from the irish longitudinal study on ageing (TILDA)
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OBJECTIVES: This study aims to examine the extent to which statins are used by adults at high risk of cardiovascular disease (CVD) compared to European clinical guidelines. The high-risk groups examined are those with (1) known CVD, (2) known diabetes and (3) a high or very high risk (≥5%) of CVD mortality based on Systematic COronary Risk Evaluation (SCORE). DESIGN: This study is cross-sectional in design using data from the first wave (2009-2011) of The Irish Longitudinal Study on Ageing (TILDA). SETTING AND PARTICIPANTS: The sample (n=3372) is representative of community living adults aged 50-64 years in Ireland. RESULTS: Statins were used by 68.6% (95% CI 61.5% to 75.8%) of those with known CVD, 57.4% (95% CI 49.1% to 65.7%) of those with known diabetes and by 19.7% (95% CI 13.0% to 26.3%) of adults with a SCORE risk ≥5%. Over a third (38.5%, 95% CI 31.0% to 46.0%) of those with known CVD, 46.8% (95% CI 38.4% to 55.1%) of those with known diabetes and 85.2% (95% CI 79.3% to 91.1%) of those with a SCORE risk ≥5% were at or above the low-density lipoprotein cholesterol (LDL-C) target of 2.5 mmol/L specified in the 2007 European guidelines. CONCLUSIONS: Despite strong evidence and clinical guidelines recommending the use of statins for secondary prevention, a gap exists between guidelines and practice in this cohort. It is also of concern that a low proportion of adults with a SCORE risk ≥5% were taking statins. A policy response that strengthens secondary prevention, and improves risk assessment and shared decision-making in the primary prevention of CVD is required.
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Usage of statins in primary prevention settings is even lower, even in developed countries, where a vast majority of patients are not on regular statin therapy.
“The usage of statins in primary prevention settings is even lower, even in developed countries, where a vast majority of the patients are not on regular statin therapy [40].”
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Kasliwal, R. R., Bansal, M., Gupta, R., Shah, S., Dani, S., Oomman, A., Pai, V., Prasad, G. M., Singhvi, S., Patel, J., et al. (2016) · Nutrition · doi:10.1016/j.nut.2016.01.012 · Cited by 17 · see citing works
- Authors
- Murphy, C., Bennett, K., Fahey, T., Shelley, E., Graham, I., & Kenny, R. A.
- Affiliations
- Department of Medical Gerontology, Trinity College, Dublin, Ireland
- Trinity College Dublin (IE)
- Royal College of Surgeons in Ireland (IE)
- Health Service Executive (IE)
- Tallaght University Hospital (IE)
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2015-07
- Volume
- 5
- Issue
- 7
- Pages
- e008017
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4513517
- OpenAlex
- W1905965048
- Cited by
- 25
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2018: 5 · 2017: 2 · 2016: 8
- FWCI
- 5.03
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Dublin City University Open Access Institutional Repository (Dublin City University) (acceptedVersion, cc-by-nc)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion, cc-by-nc-sa)
- Royal College of Surgeons in Ireland (submittedVersion, cc-by-nc)
- Figshare (submittedVersion, cc-by-nc)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Funders
- Health Research Board (HRC-2014-1)
- Irish Heart Foundation
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Keywords
- statin use, cardiovascular disease, cardiovascular risk, SCORE risk assessment, diabetes mellitus, LDL cholesterol targets, secondary prevention, guideline adherence, primary prevention, shared decision-making, older adults, Ireland
- MeSH terms
- Cardiovascular Diseases, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Hypercholesterolemia, Ireland, Cholesterol, LDL, Longitudinal Studies, Male, Middle Aged, Risk Factors, Practice Guidelines as Topic, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Guideline Adherence, Secondary Prevention
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