Statin adherence a must to reduce stroke risk among hyperlipidemia patients
Patients with hyperlipidemia who take their statin medication as prescribed appear to do well, with treatment adherence conferring significant protection against the risk of ischaemic and haemorrhagic strokes, as reported in a study.
The study used data from the Korean National Health Insurance Service-National Sample Cohort and included 128,052 and 129,390 participants with hyperlipidemia for ischaemic and haemorrhagic stroke analyses, respectively.
Statin adherence was considered in terms of the proportion of days covered considered (PDC), which was calculated as the total number of days of supply divided by the number of days in the follow-up period. A PDC of ≥80 percent was deemed ‘good’, 60–80 percent was ‘medium’, and <60 percent was ‘poor’.
Among the 128,052 participants selected for the ischaemic stroke analysis, 9,808 (7.7 percent) had a stroke, 84,778 (66.2 percent) exhibited poor PDC, and 20,814 (16.3 percent) showed good PDC. Among the 129,390 participants selected for the haemorrhagic stroke analysis, 2,541 (2.0 percent) had a stroke, 85,656 (66.1 percent) showed poor PDC, and 21,030 (16.3 percent) demonstrated good PDC.
In a multivariable Cox proportional hazards model, participants with poor vs good PDC exhibited higher risks of ischaemic (hazard ratio [HR], 1.09, 95 percent confidence interval [CI], 1.03–1.15) and haemorrhagic stroke (HR, 1.37, 95 percent CI, 1.22–1.54).
The association between poor PDC and higher risk of ischaemic stroke was pronounced among women (HR, 1.17, 95 percent CI, 1.09–1.26), while that of poor PDC and increased risk of haemorrhagic stroke was stronger among men (HR, 1.55, 95 percent CI, 1.27–1.90). Finally, individuals with disabilities who had poor vs good PDC were at higher risk of ischaemic stroke (HR, 1.55, 95 percent CI, 1.24–1.93).