Many High-Risk Patients Do Not Receive Cholesterol-Lowering Therapies
Posted on: Tuesday, 14 March 2006, 21:00 CST
ATLANTA, March 14 /PRNewswire/ -- More than half of patients with high blood pressure and other cardiac risk factors are not receiving potentially life-saving cholesterol-lowering statin drugs. This data was presented by ValueMedics Research, LLC, based in Northern Virginia, at the American College of Cardiology's 55th Annual Scientific Session. This research illustrates the need to integrate into clinical practice the findings from recent clinical trials, which demonstrate the unequivocal cardiovascular benefits of statin therapy in hypertensive patients with high cholesterol, heart disease or diabetes. A separate study also presented by ValueMedics Research showed that pill burden is a significant predictor of nonadherence to concomitant antihypertensive and lipid-lowering therapy.
In the first study, researchers examined how frequently high-risk patients were prescribed statins during the first year of treatment for high blood pressure in a U.S. managed care setting, using data from more than 75 health plans across the US. Of the 142,389 patients in the study, about 30 percent had been diagnosed with high cholesterol, yet more than half of these patients -- 53 percent -- received no statin therapy at all during the first year after starting hypertension medication. Fewer than one in five were already on statin therapy when they started treatment for high blood pressure and only another one-third began taking statins in the first year.
In the group of patients who had high blood pressure and established heart disease (14,647 patients), only 11 percent were already on statin therapy, with an additional 31 percent starting during the first year after hypertension treatment began. Yet again, more than half (58 percent) of this group did not receive a statin. Similarly, the majority of the study populations with diabetes (17,567 patients) and with 3 or more heart disease risk factors (15,701 patients) did not receive a statin in the first year (61% and 54%, respectively).
"While research demonstrates that statin therapy could benefit hypertension patients who have other cardiac risk factors, the majority of these patients were not receiving cholesterol-lowering statin drugs," said Richard H. Chapman, Ph.D., of ValueMedics Research, lead author of the study. "Statins are the standard of care for this group of patients, and they should be prescribed along with antihypertensive therapy. Failing to do so may restrict patients' access to potentially life-saving treatment."
Another ValueMedics study presented today at ACC found that polypharmacy is an important predictor of patient nonadherence to blood pressure and cholesterol medications. The authors studied the number of prescriptions patients were already taking when they started blood pressure and cholesterol medication, and found that it was a significant predictor of nonadherence with the new cardiovascular regimen. The study included over 8,000 patients initiating antihypertensive and lipid-lowering therapy. In patients taking 0, 1, and 2 other medications, median adherence was 59%, 49%, and 42%, respectively. For those taking 8, 9, and greater than or equal to 10 medications, median adherence was 33%, 28%, and 25%, respectively. In a surprising finding, the impact of each additional medication appears to be greatest in patients taking the fewest medications to start with.
The results build on a previous study by ValueMedics researchers, which documented low overall levels of adherence to blood pressure and cholesterol medications among patients at elevated risk of heart disease. "Even after adjustment for other known causes of poor adherence, there was a moderate correlation with pill burden," says Josh Benner, PharmD, ScD, Principal of ValueMedics Research and lead author of the study. "Our findings suggest that it may be worthwhile for physicians and pharmacists to look for ways to reduce the number of medications their patients are taking, because patients who take the most medications seem to have the lowest levels of adherence."
ValueMedics Research is a health care research and consulting firm located in Northern Virginia.
The studies were supported by Pfizer, Inc. The authors of the first study were: Richard H. Chapman, PhD, Allison A. Petrilla, BA, and Joshua S. Benner, PharmD, ScD, of ValueMedics Research; and Simon Tang, MPH, and Lance Berman, MD, of Pfizer, Inc. Authors of the second study were: Joshua S. Benner, PharmD, ScD, Allison A. Petrilla, BA, and Richard H. Chapman, PhD, of ValueMedics Research; Simon Tang, MPH, and Noah Rosenberg, MD, of Pfizer, Inc; and J. Sanford Schwartz of the School of Medicine and Wharton School, University of Pennsylvania.
CONTACT: Karen Joy of ValueMedics Research, LLC, +1-703-286-2863, Karen.Joy@valuemedics.com.
ValueMedics Research, LLC
CONTACT: Karen Joy of ValueMedics Research, LLC, +1-703-286-2863,Karen.Joy@valuemedics.com
Source: PRNewswire
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