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ABSTRACT: Background
There remains uncertainty regarding optimal primary atherosclerotic cardiovascular disease (ASCVD) prevention practices for older adults.Objective
To assess statin treatment patterns and incident ASCVD among older patients for primary prevention across the spectrum of ASCVD risk.Design
Retrospective cohort study of participants without ASCVD aged 65-79 years. Patients were stratified by age (65-69, 70-75, > 75 years) and 10-year ASCVD risk category (low/borderline, intermediate, high) based on the Pooled Cohort Equations. Multivariable logistic regressions were used to identify predictors of moderate- or high-intensity statin prescriptions. Cox proportional models were used to estimate hazard ratios (HRs) for incident ASCVD.Participants
Patients aged 65-79 years without ASCVD from a Northern California health system.Main measures
Statin prescriptions and incident ASCVD events.Key results
There were 54,066 patients, with 10,288 (19%) aged > 75 years and 57% women. Compared with younger groups, adults > 75 years were less likely to be prescribed moderate- or high-intensity statin prescriptions across ASCVD risk groups (all p < 0.001); this persisted after multivariable adjustment including for ASCVD risk (odds ratio [OR] 0.80, 95% confidence interval [CI] 0.74-0.86). Adults > 75 years were more likely to experience incident ASCVD (HR 1.42, 95% CI 1.23-1.63). Women (OR 0.85, 95% CI 0.81-0.89) and underweight older adults (OR 0.45, 95% CI 0.33-0.61) were also less likely to receive moderate- or high-intensity statins.Conclusions
Among older adults aged 65-79 years without prior ASCVD, those > 75 years of age were less likely to receive moderate- or high-intensity statins regardless of ASCVD risk compared with their younger counterparts, while experiencing more incident ASCVD. Efforts are warranted to study the reasons for age-based differences in statin use in older adults, particularly those at highest ASCVD risk.
SUBMITTER: Sarraju A
PROVIDER: S-EPMC9411428 | biostudies-literature | 2022 Aug
REPOSITORIES: biostudies-literature
Sarraju Ashish A Spencer-Bonilla Gabriela G Chung Sukyung S Gomez Sofia S Li Jiang J Heidenreich Paul P Palaniappan Latha L Rodriguez Fatima F
Journal of general internal medicine 20210910 11
<h4>Background</h4>There remains uncertainty regarding optimal primary atherosclerotic cardiovascular disease (ASCVD) prevention practices for older adults.<h4>Objective</h4>To assess statin treatment patterns and incident ASCVD among older patients for primary prevention across the spectrum of ASCVD risk.<h4>Design</h4>Retrospective cohort study of participants without ASCVD aged 65-79 years. Patients were stratified by age (65-69, 70-75, > 75 years) and 10-year ASCVD risk category (low/borderl ...[more]