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Time trends in the use of cholesterol-lowering agents in older adults: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:27 America/Los_Angeles — eenright
| Title | Time trends in the use of cholesterol-lowering agents in older adults: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 1998 |
| Authors | Lemaitre, RN, Furberg, CD, Newman, AB, Hulley, SB, Gordon, DJ, Gottdiener, JS, McDonald, RH, Psaty, BM |
| Journal | Arch Intern Med |
| Volume | 158 |
| Issue | 16 |
| Pagination | 1761-8 |
| Date Published | 1998 Sep 14 |
| ISSN | 0003-9926 |
| Keywords | Aged, Anticholesteremic Agents, Cholesterol, LDL, Cohort Studies, Female, Humans, Hypercholesterolemia, Male, Prevalence, Risk Factors, United States |
| Abstract | <p><b>OBJECTIVES: </b>To describe recent temporal patterns of cholesterol-lowering medication use and the characteristics that may have influenced the initiation of cholesterol-lowering therapy among those aged 65 years or older.</p><p><b>SUBJECTS AND METHODS: </b>A cohort of 5201 adults 65 years or older were examined annually between June 1989 and May 1996. We added 687 African American adults to the cohort in 1992-1993. We measured blood lipid levels at baseline and for the original cohort in the third year of follow-up. We assessed the use of cholesterol-lowering drugs at each visit.</p><p><b>RESULTS: </b>The prevalence of cholesterol-lowering drug use in 1989-1990 was 4.5% among the men and 5.9% among the women; these figures increased over the next 6 years to 8.1% and 10.0%, respectively, in 1995-1996. There was a 4-fold increase in the use of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors during the 6 years of follow-up, from 1.9% of all participants in 1989-1990 to 7.5% in 1995-1996. The use of bile acid sequestrants, nicotinic acid, and probucol declined from initial levels of less than 1% each. Among the participants who were untreated in 1989-1990, but eligible for cholesterol-lowering therapy after a trial of dietary therapy according to the 1993 guidelines of the National Cholesterol Education Panel, less than 20% initiated drug therapy in the 6 years of follow-up, even among subjects with a history of coronary heart disease. Among participants untreated at baseline but eligible for either cholesterol-lowering therapy or dietary therapy, initiation of cholesterol-lowering drug therapy was directly associated with total cholesterol levels, hypertension, and a history of coronary heart disease, and was inversely related to age, high-density lipoprotein cholesterol levels, and difficulties with activities of daily living. Other characteristics that form the basis of the 1993 National Cholesterol Education Panel guidelines-diabetes, smoking, family history of premature coronary heart disease, and total number of risk factors-were not associated with the initiation of cholesterol-lowering drug therapy.</p><p><b>CONCLUSIONS: </b>Given the clinical trial evidence for benefit, those aged 65 to 75 years and with prior coronary heart disease appeared undertreated with cholesterol-lowering drug therapy.</p> |
| Alternate Journal | Arch. Intern. Med. |
| PubMed ID | 9738605 |
| Grant List | N01 HC 85079 / HC / NHLBI NIH HHS / United States N01 HC 85080 / HC / NHLBI NIH HHS / United States N01 HC 85081 / HC / NHLBI NIH HHS / United States |