title: Use of secondary preventive medications in patients with atherosclerotic disease in urban China: a cross-sectional study of 16, 860 patients.
abstract: BACKGROUND
  Despite considerable improvements in the care of patients with cardiovascular disease in various populations over the last few decades, there are still limited data about long-term treatment patterns among patients with various atherosclerotic vascular conditions in China, especially the use of statin therapy.
  
  
  METHODS
  Between June 2007 and October 2009, 16 860 patients aged 50 - 80 years with established history of atherosclerotic vascular disease (coronary heart disease (CHD), atherosclerotic cerebrovascular disease (CVD), or peripheral arterial disease (PAD)) from 51 hospitals in 14 cities of China were screened for a large randomized trial. Detailed information about current use of statins and various other treatments was recorded and analyzed by prior disease history, adjusting for various baseline characteristics.
  
  
  RESULTS
  Among the 16 860 patients, the mean age was 63 years and 74% were male. Overall, 78% of the patients had documented CHD, 40% had CVD, 5% had PAD and 21% reported more than one condition. The median time from initial diagnosis of vascular disease to screening was 18 months. At screening, the proportions who took various treatments were 83% for antiplatelet agents, 49% for beta-blockers, 47% for statins and 28% for angiotensin-converting enzyme inhibitors. The proportion treated with statin was much higher in CHD than in CVD or PAD patients (61% vs. 10% vs. 22% respectively) and decreased significantly with time from initial diagnosis. Simvastatin (mainly 20 mg) and atorvastatin (mainly 10 mg) each accounted for about 40% of total statin use.
  
  
  CONCLUSIONS
  In urban China, there is still significant underuse of various proven secondary preventive therapies, with particularly low use of statins in patients with ischaemic stroke.
authors.affiliation: Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Yi-ping
authors.initials: YP
authors.lastname: Chen
authors.forename: Xi
authors.initials: X
authors.lastname: Li
authors.forename: Jane
authors.initials: J
authors.lastname: Armitage
authors.forename: Fang
authors.initials: F
authors.lastname: Feng
authors.forename: Jia-min
authors.initials: JM
authors.lastname: Liu
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.forename: Hai-bo
authors.initials: HB
authors.lastname: Zhang
authors.forename: Dan
authors.initials: D
authors.lastname: Zhang
authors.forename: Wuhan-bilige
authors.initials: WB
authors.lastname: Hundei
authors.forename: Zheng-ming
authors.initials: ZM
authors.lastname: Chen
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Jemma C
authors.initials: JC
authors.lastname: Hopewell
authors.forename: Elsa
authors.initials: E
authors.lastname: Valdes-Marquez
authors.forename: Martin
authors.initials: M
authors.lastname: Landray
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Jiang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000188:drug therapy*; D000069059:Atorvastatin; D002561:Cerebrovascular Disorders / Q000188:drug therapy; D003324:Coronary Artery Disease / Q000188:drug therapy; D003430:Cross-Sectional Studies; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000188:drug therapy; D011758:Pyrroles / Q000627:therapeutic use; D055502:Secondary Prevention / Q000379:methods*; D019821:Simvastatin / Q000627:therapeutic use
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin