Statin therapy in real clinical practice in elderly patients with hyperlipidemia and coronary heart disease. Russian program EFFORT

Abstract

Aim. To investigate the use of statins and patients’ adherence to statin therapy in elderly patients (pts) with hyperlipidemia (HL) and coronary heartdisease (CHD) in real clinicalpractice. Methods. The program was conducted in health care facilitiesfrom 2010 to 2011. 959pts aged ± 65yrs (mean age 68.9 ± 0.2yrs) with HL and CHD were enrolled into the program. There were 47.5% women participating in theprogram. Results. The high prevalence of coronary riskfactors was revealed in cohort of elderly pts with HL and CHD: arterial hypertension (93%), left ventricular hypertrophy (82%), abdominal obesity (59%), type 2 diabetes mellitus (25%). 20.4% of pts were smokers and 97.7% were physical inactive. Myocardial infarction and stroke have experienced 31.6% and 9.1% of the pts, respectively. Statins were recommended for 77% of the elderly pts; 18.7% of them refused to take statins and 41.5% took them as courses. The main reasons for low adherence to statin therapy in elderly included fear of adverse reactions (46%); a lack of motivation to be treated (29.4%); polypragmasia (27.6%), memoryproblems (26.5%), low-effidency treatment(18.8%). Actually only 11.7% of the elderly pts, who had taken the statins refused to use it because of adverse events (AEs) being developed. There were mild and moderate muscular/tensions AEs in 9.2% of all pts and an asymptomatic creatinephosphokinase increase in 0.83%. The costof the drug restricted it’s use to only 13.5% of the elderlypts. Conclusions. The Russian program EFFORT included a cohort of elderlypts has revealed the high prevalence of riskfactors among them andpoorcontrol, determined by low pts adherence to the statin therapy.