title: Statin use in adults at high risk of cardiovascular disease mortality: cross-sectional analysis of baseline data from The Irish Longitudinal Study on Ageing (TILDA).
abstract: OBJECTIVE
  This study aims to examine the extent to which statins are used by adults at high risk of cardiovascular disease (CVD) compared to European clinical guidelines. The high-risk groups examined are those with (1) known CVD, (2) known diabetes and (3) a high or very high risk (≥5%) of CVD mortality based on Systematic COronary Risk Evaluation (SCORE).
  
  
  METHODS
  This study is cross-sectional in design using data from the first wave (2009-2011) of The Irish Longitudinal Study on Ageing (TILDA).
  
  
  METHODS
  The sample (n=3372) is representative of community living adults aged 50-64 years in Ireland.
  
  
  RESULTS
  Statins were used by 68.6% (95% CI 61.5% to 75.8%) of those with known CVD, 57.4% (95% CI 49.1% to 65.7%) of those with known diabetes and by 19.7% (95% CI 13.0% to 26.3%) of adults with a SCORE risk ≥5%. Over a third (38.5%, 95% CI 31.0% to 46.0%) of those with known CVD, 46.8% (95% CI 38.4% to 55.1%) of those with known diabetes and 85.2% (95% CI 79.3% to 91.1%) of those with a SCORE risk ≥5% were at or above the low-density lipoprotein cholesterol (LDL-C) target of 2.5 mmol/L specified in the 2007 European guidelines.
  
  
  CONCLUSIONS
  Despite strong evidence and clinical guidelines recommending the use of statins for secondary prevention, a gap exists between guidelines and practice in this cohort. It is also of concern that a low proportion of adults with a SCORE risk ≥5% were taking statins. A policy response that strengthens secondary prevention, and improves risk assessment and shared decision-making in the primary prevention of CVD is required.
authors.affiliation: Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: Catriona
authors.identifier: http://orcid.org/0000-0002-3262-1130
authors.initials: C
authors.lastname: Murphy
authors.affiliation: Department of Pharmacology and Therapeutics, Trinity College, Dublin, Ireland.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bennett
authors.affiliation: Department of General Practice, HRB Centre for Primary Care Research, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland.
authors.forename: Tom
authors.initials: T
authors.lastname: Fahey
authors.affiliation: Department of Public Health, Health Service Executive, Dublin, Ireland.
authors.forename: Emer
authors.initials: E
authors.lastname: Shelley
authors.affiliation: Department of Cardiology, Tallaght Hospital, Dublin, Ireland.
authors.forename: Ian
authors.initials: I
authors.lastname: Graham
authors.affiliation: Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: Rose Anne
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007494:Ireland / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: EPIDEMIOLOGY; PRIMARY CARE