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Statin Use in Canadians: Trends, Determinants and Persistence

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Abstract

Background

Regular statin use is an important tool in chronic disease management, lowering cholesterol levels and reducing risk of cardiovascular disease (CVD). The objectives of this study are to describe statin use in Canada by comorbidity and lifestyle risk factors, and determine persistence in statin use.

Methods

The longitudinal National Population Health Survey, 1994–2002, is a random sample of the 1994 Canadian population and five interviews were conducted at two-year intervals. A total of 8,198 respondents, aged 20 in 1994, completed all five interviews. Information collected included demographic variables, medication use, CVD lifestyle risk factors, CVD, diabetes and hypertension.

Results

Age-adjusted rates of statin use increased from 1.6% to 7.8% over the period 1994–2002. Statin use was higher with increasing age, diabetes, BMI, physician visits, and insurance for prescription medication. Although persons with CVD were more likely to take statins than those without, by 2002 still only 32.7% of heart patients were taking statins. Statin use did not increase linearly with increasing numbers of CVD risk factors or comorbidities. Of the 441 persons reporting statin use in 2000, 74.6% were still taking them in 2002. People who completed their high school education were more likely to continue taking statins than those who did not complete high school.

Conclusion

While statin use increased over time, was associated with CVD and diabetes, and to a lesser extent with increased BMI, a substantive underuse in high-risk patients remains. Helping high-risk people to increase statin use continues to be a priority for health care professionals.

Résumé

Contexte

La prise régulière de statine est un outil important dans le traitement des maladies chroniques et la réduction de la cholestérolémie et des risques de maladie cardiovasculaire (MCV). Nous avons voulu décrire l’utilisation des statines au Canada en fonction de deux facteurs (la comorbidité et le risque lié aux habitudes de vie) et déterminer la persistance dans la prise de statine.

Méthode

Cinq entretiens ont été menés tous les deux ans dans le cadre de l’Enquête nationale sur la santé de la population (1994–2002), une enquête longitudinale auprès d’un échantillon aléatoire de la population canadienne. En tout, 8 198 répondants âgés de 20 ans en 1994 se sont prêtés aux cinq entretiens. Les données recueillies englobaient des variables démographiques, la consommation de médicaments, les facteurs de risque de MCV liés aux habitudes de vie, les MCV, le diabète et l’hypertension artérielle.

Résultats

Les taux de prise de statine rajustés selon l’âge ont grimpé de 1,6 % à 7,8 % entre 1994 et 2002. La prise de statine s’élevait avec l’âge, le diabète, l’indice de masse corporelle (IMC), les visites chez le médecin et le fait d’avoir une assurance-médicaments. Les personnes ayant une MCV étaient plus susceptibles de prendre des statines que les personnes qui n’en avaient pas, mais en 2002, les cardiaques qui prenaient des statines n’étaient encore que 32,7 %. La prise de statine n’a pas augmenté de façon linéaire avec les facteurs de risque de MCV ou les comorbidités. Sur les 441 personnes qui prenaient des statines en 2000, 74,6 % en prenaient encore en 2002. Les diplômés du secondaire étaient plus susceptibles d’avoir continué à prendre des statines que les non-diplômés.

Conclusion

La prise de statine a augmenté au fil du temps, et elle était associée à l’augmentation des MCV, du diabète et, dans une moindre mesure, de l’IMC, mais les patients à risque élevé sousutilisaient encore beaucoup ce médicament. Aider les personnes à risque élevé à accroître leur prise de statine demeure donc une priorité pour les professionnels de la santé.

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Author information

Authors and Affiliations

  1. Centre for Chronic Diseases Prevention and Control, Public Health Agency of Canada, AL #6702A, 120 Colonnade Road, Ottawa, ON, K1A 0K9, Canada

    C. Ineke Neutel PhD, FACE, FISPE, Howard Morrison PhD, FACE & Margaret de Groh PhD

  2. Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Canada

    C. Ineke Neutel PhD, FACE, FISPE & Howard Morrison PhD, FACE

  3. Departments of Medicine, and Pharmacology & Therapeutics, Faculty of Medicine, University of Calgary, Calgary, AB, Canada

    Norm R. C. Campbell MD, FRCPC, FACP

Authors
  1. C. Ineke Neutel PhD, FACE, FISPE
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  2. Howard Morrison PhD, FACE
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  3. Norm R. C. Campbell MD, FRCPC, FACP
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  4. Margaret de Groh PhD
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Corresponding author

Correspondence to C. Ineke Neutel PhD, FACE, FISPE.

Additional information

Sources of support: Dr. Norm Campbell has received research funds for epidemiological research from Pfizer Canada, Sanofi-Aventis, Bristol Myers Squibb, Servier Canada, and Merck Frosst Canada, travel grants from Servier Canada, Bristol Myers Squibb and Biovail, and honoraria for speaking from most companies producing trade-brand antihypertensive drugs in Canada.

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Neutel, C.I., Morrison, H., Campbell, N.R.C. et al. Statin Use in Canadians: Trends, Determinants and Persistence. Can J Public Health 98, 412–416 (2007). https://doi.org/10.1007/BF03405430

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