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Risk factors affecting the failed low‐density lipoprotein level achievement rate in working‐age male population at high cardiovascular risk
Author(s) -
Momo Kenji,
Yasu Takeo,
Yasui Hiroshi,
Kuroda Seiichiro
Publication year - 2019
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12847
Subject(s) - medicine , demography , risk factor , population , gerontology , environmental health , sociology
What is known and objective The aim of this study was to clarify the low‐density lipoprotein (LDL)‐C level achievement rate and detect factors affecting the failed LDL‐C achievement rate in patients treated with statins and anti‐platelet agents using a large insurance claim database and health check‐up data. Methods Access to a large health insurance claims database, and health check‐up data were obtained from Japan Medical Data Center (JMDC) Co. Ltd., Tokyo. The database was searched to identify employed working‐age male patients who had started treatment with statin and anti‐platelet drugs for the secondary prevention of cardiovascular events. These patients were enrolled in the retrospective cohort study, which included screening at 3 months and observation for 3 years. LDL‐C levels were obtained from the annual health check‐up data. The achievement rate for LDL‐C < 100 was assessed for three consecutive years. Adherence was assessed using the proportion of days covered (PDC) for the statin, which was calculated from prescription data over a 3‐year period. Results and discussion Overall, 294 patients (male/female, 294/0; age, 47.8 ± 6.0 years; body mass index, 24.8 ± 4.2 kg/m 2 ; hypertension, 76.2%; and diabetes mellitus, 20.4%) were included. The LDL‐C achievement rate for three consecutive years after starting treatment with statin and aspirin was 49.7%, 51.4% and 45.9%, respectively. Factors affecting failed LDL‐C on adjusted odds were lower adherence to PDC [0.96 (0.94‐0.99), P < 0.001, 1% increase] and higher baseline LDL‐C [1.01 (1.00‐1.02), P = 0.037, 1 mg/dL increase]. What is new and conclusion Our results suggest that in the working‐age male population need to improve statin adherence, especially those with higher baseline LDL‐C levels.