Cholesterol- and blood pressure-lowering drug use for secondary cardiovascular prevention in 2004 - 2013 Europe

Background: Suboptimal use of cardiovascular prevention medications has been reported. We report recent trends in secondary cardiovascular disease (CVD) prevention drug use in Europe. Design: Study of Health and Retirement in Europe (SHARE), a large longitudinal 2004-2013 cohort study in middle-aged and elderly Europeans. Methods: Cross-sectional and panel logistic regression models were used to study trends in cholesterol- and blood pressure (BP)-lowering drug use and effects of individual characteristics among participants with CVD in SHARE. Results: 21,371 SHARE participants reported cardiovascular disease and, at initial report, 40% and 60% of them used cholesterol- or BP-lowering drugs, respectively. Increasing cross-sectional time trends were observed for both medication classes (odds ratios [OR] of use in 2013 vs 2004, 1.6 [95%CI 1.4-1.7] and 1.5 [1.4-1.6], respectively). However, among individuals with multiple observations, the use of both classes declined over time (2013 vs 2004 OR 0.63 [0.51-0.77] and 0.68 [0.55-0.84]; both trend p<0.001), and with increasing duration since last cardiovascular event (OR 0.74 [0.60-0.91], trend p=0.01 and OR 0.82 [0.66-1.03], trend p=0.06, respectively for durations of 9 years or more versus less than one year). Among people with CVD, those obese, retired or with hypercholesterolemia, hypertension, worse self-perceived health, and, in the case of lipid-lowering medication, with diabetes, were more likely to use these medications. Conclusions: Despite moderately increasing cross-sectional time trends, the use of secondary CVD prevention drugs remains low in Europe with substantial discontinuation over time and with increasing duration from an acute cardiovascular event

Cholesterol-and blood-pressure-lowering drug use for secondary cardiovascular prevention in 2004-2013 Europe

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: DA received funding by a university research grant, awarded by the Hamburg Center for Health Economics, University of Hamburg, Germany. This paper uses data from SHARE Wave 1-5, as of 31 March 2015. The SHARE data collection has been primarily funded by the European Commission through the 5th Framework Programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life), through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, and SHARELIFE, CIT4-CT-2006-028812) and through the 7th Framework Programme (SHARE-PREP, N° 211909, SHARE-LEAP, N° 227822 and SHARE M4, N° 261982). Additional funding from the US National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11 and OGHA 04-064) and the German Ministry of Education and Research as well as from various national sources is gratefully acknowledged (www.share-project.org)