Low prevalence of lipid lowering drug use in older men with established coronary heart disease.
OBJECTIVE
To determine the prevalence and correlates of lipid lowering drug use among older British men with established coronary heart disease (CHD).


METHODS
Cross sectional survey within a cohort study (British regional heart study) carried out at 20 years of follow up in 1998-2000.


METHODS
General practices in 24 British towns.


METHODS
3689 men aged 60-75 years (response rate 76%).


METHODS
Diagnoses of myocardial infarction and angina based on detailed review of general practice records. Lipid lowering drug use and blood cholesterol concentrations ascertained at 20 year follow up examination.


RESULTS
Among 286 men with definite myocardial infarction, 102 (36%) were taking a lipid lowering drug (93 (33%) a statin); among 360 men with definite angina without myocardial infarction, 84 (23%) were taking a lipid lowering drug (78 (21%) a statin). Most men with documented CHD who were not receiving a lipid lowering drug had a total cholesterol concentration of 5.0 mmol/l or more (87% of those with myocardial infarction, 82% with angina). Fewer than half of men with CHD receiving a statin had a total cholesterol concentration below 5.0 mmol/l (45% of those with myocardial infarction and 47% of those with angina). Only one third of the men taking a statin were receiving trial validated dosages. Among men with CHD, a history of revascularisation, more recent diagnosis, and younger age at diagnosis were associated with a higher probability of receiving lipid lowering drug treatment.


CONCLUSIONS
Among patients with established CHD, the prevalence of lipid lowering drug use remains low and statin regimens suboptimal. Major improvements in secondary prevention are essential if the benefits of statins are to be realised.
Whincup
P H
PH
Department of Public Health Sciences, St George's Hospital Medical School, London SW17 ORE, UK. p.whincup@sghms.ac.uk
Emberson
J R
JR
Lennon
L
L
Walker
M
M
Papacosta
O
O
Thomson
A
A
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D006113:United Kingdom / Q000453:epidemiology
D000960:Hypolipidemic Agents; D002784:Cholesterol