Cardiovascular Drugs and Therapy

, Volume 21, Issue 4, pp 311-316

First online:

Predictors of Adherence to Statins for Primary Prevention

  • Devin M. MannAffiliated withDivision of General Internal Medicine, Mount Sinai School of Medicine Email author 
  • , John P. AllegranteAffiliated withTeachers College and Mailman School of Public Health, Columbia University
  • , Sundar NatarajanAffiliated withDivision of General Internal Medicine, New York University School of Medicine and the VA Medical Center
  • , Ethan A. HalmAffiliated withDivision of General Internal Medicine, Mount Sinai School of Medicine
  • , Mary CharlsonAffiliated withDivision of General Internal Medicine and Center for Complementary and Integrative, Weill Medical College, Cornell University

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Statins are potent drugs for reducing cholesterol and cardiovascular disease; however, their effectiveness is significantly compromised by poor adherence. This prospective study was designed to identify potentially modifiable patient factors including medication, disease, and diet beliefs related to statin adherence.


Veterans (n = 71) given their first prescription of a statin for primary prevention were interviewed at baseline, 3 months, and 6 months regarding medication, disease, and diet beliefs along with self-reported statin adherence.


At 6-month follow-up, 55% of the cohort was non-adherent with 10% reporting never having started their statin, 50% reporting misconceptions about the duration of treatment and a median use of <2 months among those who discontinued their statin. Multivariate predictors of non-adherence were expected short treatment duration (OR = 3.6, 1.4–9.4), low perceived risk of myocardial infarction (OR = 3.1, 1.1–8.7), concern about potential harm from statins (OR = 2.5, 1.0–6.3), being Hispanic (OR = 3.9, 1.0–15.2), and younger age (OR = 4.2, 1.1–15.8).


Poor adherence to statins was common in this primary prevention population with frequent early discontinuation despite access to low-cost medicines. Patient factors regarding the perception of risk, toxic effects of medication, expected treatment duration, as well as socio-demographic factors, were significant predictors of poor adherence and warrant further exploration.

Key words

adherence cardiovascular disease statins primary prevention predictor health beliefs