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Family history of cardiovascular disease and influence on statin therapy persistence

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

Persistence to statins is low, presumably due to lack of perception of risk. Having a close relative suffering from cardiovascular disease (CVD) might increase persistence to statins. We investigated whether family history of CVD influences the discontinuation of statin treatment.

Methods

A population-based cohort study was performed. Swedish registers on dispensed drugs, hospitalization and cause of death were linked to the Multi-generation Register. Incident statin users 20–72 years of age were identified between 2006 and 2007 and followed until 30 June 2009. Family history of CVD was defined as the presence of relatives with a previous cardiovascular event. Cox regression was used to study discontinuation and estimate the effect of the family history of CVD, adjusting for gender, age, education, income, healthcare provider, prevention’s type, birth’s country and residence’s county. Stratified analysis by type and severity of cardiovascular event was performed.

Results

A total of 86,002 patients were enrolled; 61.5 % had a family history of CVD. Discontinuation of statin therapy was not associated with family history of CVD (HR: 0.98; 95 % CI:0.96–1.01), except for patients with a family history of death from myocardial infarction (MI) (HR: 0.95 95 % CI:0.92–0.98). Young age, foreign background, low income, and statin for primary prevention and for secondary prevention when prescribed by a general practitioner were associated with higher risk of statin discontinuation.

Conclusions

Having relatives suffering from CVD did not consistently influence the persistence to statin treatment. A family history of death from MI had a slight significant positive effect on statin persistence, though not clinically relevant.

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Conflict of interest

The study was supported by research funding from Astrazeneca, Merck and Pfizer. The funders had no role in the data collection and analysis and were not involved in the interpretation of results, writing or approval of the manuscript.

Authors’ contributions

AC was responsible for study design, analysis, interpretation of data, drafting the article;

HK and AS contributed to the conception and study design, interpretation of data and reviewed the manuscript critically for important intellectual content;

ML contributed for statistical data analysis and reviewed the manuscript critically for important intellectual content;

BW contributed to interpretation of data and reviewed the manuscript for important intellectual content;

IAB reviewed the manuscript critically for important intellectual content;

MA was responsible for conception and study design, analysis, interpretation of data, drafting the article and study supervision.

All authors approved the final version of the manuscript.

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Authors and Affiliations

  1. Centre for Pharmacoepidemiology Karolinska Institutet T2, Karolinska University Hospital, SE 171 76, Stockholm, Sweden

    Anna Citarella, Helle Kieler, Anders Sundström, Marie Linder, Björn Wettermark, Ingegärd Anveden Berglind & Morten Andersen

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  1. Anna Citarella
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Correspondence to Anna Citarella.

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Fig. 1

Survival distribution of persistence with statin therapy stratified by type of prevention and family history of cardiovascular disease (CVD) adjusted for gender, age, education, individual income, health care provider, country of birth, and county of residence (JPEG 351 kb)

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Citarella, A., Kieler, H., Sundström, A. et al. Family history of cardiovascular disease and influence on statin therapy persistence. Eur J Clin Pharmacol 70, 701–707 (2014). https://doi.org/10.1007/s00228-014-1659-0

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  • DOI: https://doi.org/10.1007/s00228-014-1659-0

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