Racial and ethnic disparities in cardiovascular medication use among older adults in the United States.
BACKGROUND
Despite persistent racial/ethnic disparities in cardiovascular disease (CVD) among older adults, information on whether there are similar disparities in the use of prescription and over-the-counter medications to prevent such disease is limited. We examined racial and ethnic disparities in the use of statins and aspirin among older adults at low, moderate, and high risk for CVD.


RESULTS
In-home interviews, including a medication inventory, were administered between June 2005 and March 2006 to 3005 community-residing individuals, ages 57-85 years, drawn from a cross-sectional, nationally-representative probability sample of the United States. Based on a modified version of the Adult Treatment Panel III (ATP III) risk stratification guidelines, 1066 respondents were at high cardiovascular risk, 977 were at moderate risk, and 812 were at low risk. Rates of use were highest among respondents at high cardiovascular risk. Racial differences were highest among respondents at high risk with blacks less likely than whites to use statins (38% vs. 50%, p = 0.007) and aspirin (29% vs. 44%, p = 0.008). After controlling for age, gender, comorbidity, and socioeconomic, and access to care factors, racial/ethnic disparities persisted. In particular, blacks at highest risk were less likely than their white counterparts to use statins (odds ratio (OR) 0.65, confidence interval (CI) 0.46-0.90) or aspirin (OR 0.61, CI 0.37-0.98).


CONCLUSIONS
These results, based on an in-home survey of actual medication use, suggest widespread underuse of indicated preventive therapies among older adults at high cardiovascular risk in the United States. Racial/ethnic disparities in such use may contribute to documented disparities in cardiovascular outcomes.
Qato
Dima M
DM
Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA. dqato@babies.bsd.uchicago.edu
Lindau
Stacy Tessler
ST
Conti
Rena M
RM
Schumm
L Philip
LP
Alexander
G Caleb
GC
D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000208:ethnology*; D015897:Comorbidity; D005006:Ethnicity; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012307:Risk Factors; D012959:Socioeconomic Factors
D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin