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Older Statin Initiators in Finland—Cardiovascular Risk Profiles and Persistence of Use

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Abstract

Purpose

The benefits of statin treatment initiated in advanced age are largely unknown; however, good adherence to treatment is essential for beneficial effects to be achieved also when treating older people. This study characterizes older statin initiators, including their cardiovascular risk profiles and morbidity, and investigates patterns of treatment persistence.

Methods

Longitudinal register-based study. All statin initiators in Finland aged ≥70 in 2000–2008 (n = 157,709) were identified from the nationwide Prescription Register. Using information from comprehensive health registers, the initiators were classified as having low, moderate, or high cardiovascular risk. For the initiators in 2000 and 2004, patterns of persistence were evaluated over a 4-year follow-up using the anniversary method.

Results

The annual number of statin initiators increased from 15,082 to 19,728; the proportion of those aged ≥80 increased from 12.9 to 25.8 %. The prevalence of coronary heart disease at statin initiation decreased from 45.5 to 28.1 %. Only every tenth initiator (9.2–11.7 %) was estimated to have low cardiovascular risk each year. Four in five initiators (76.9–80.5 %) persisted with statin treatment after 1 year. The probability to survive and remain persistent for 4 years was 51.6 % and the probability to discontinue within the first year without restarting in the subsequent 3 years was 9.1 %. There were no noticeable differences in persistence across the risk groups.

Conclusions

Long-term persistence with statins among older people was good across cardiovascular risk groups. These findings are consistent with the notion that the decision on long-term continuation of statin use is made during the first year of treatment.

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Acknowledgments

Authors declare no conflicts of interests. E.U, M.K and M.R participated in collecting and analyzing the data. All authors participated in interpreting the data and reviewing the manuscript. E.U wrote the final manuscript. We thank Hilkka Ruuska for her expertise in data management. The study was funded by the Finnish Social Insurance Institution. E.U had also an EVO grant from Turku City Hospital and a research grant from Betania foundation of Turku, Finland.

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Authors and Affiliations

  1. Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Medisiina C, 6. krs., Kiinanmyllynkatu 10, 20520, Turku, Finland

    Eveliina Upmeier, Maarit Jaana Korhonen, Maria Rikala, Arja Helin-Salmivaara & Risto Huupponen

  2. Unit of Clinical Pharmacology, Turku University Hospital, Turku, Finland

    Eveliina Upmeier & Risto Huupponen

  3. Department of Geriatrics, University of Turku, Turku, Finland

    Eveliina Upmeier

  4. Department of Public Health, University of Turku, Turku, Finland

    Maarit Jaana Korhonen

  5. Unit of Primary Health Care, Hospital District of Helsinki and Uusimaa, Helsinki, Finland

    Arja Helin-Salmivaara

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  1. Eveliina Upmeier
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Correspondence to Eveliina Upmeier.

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Upmeier, E., Korhonen, M.J., Rikala, M. et al. Older Statin Initiators in Finland—Cardiovascular Risk Profiles and Persistence of Use. Cardiovasc Drugs Ther 28, 263–272 (2014). https://doi.org/10.1007/s10557-014-6517-x

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