Journal article
Another treatment gap: Restarting secondary prevention medications: The Women's Health Initiative
Journal of clinical lipidology, Vol.4(1), pp.36-45
2010
DOI: 10.1016/j.jacl.2009.12.006
PMCID: PMC2845400
PMID: 20354566
Abstract
Women's long-term patterns of evidence-based preventive medication use after a diagnosis of coronary heart disease have not been sufficiently studied.
Postmenopausal women ages 50 to 79 years were eligible for randomization in the Women's Health Initiative's hormone trials if they met inclusion and exclusion criteria and were >80% adherent during a placebo-lead-in period and in the dietary modification trial if they were willing to follow a 20% fat diet. Those with adjudicated myocardial infarction or coronary revascularization after the baseline visit were included in the analysis (
n = 2627). Baseline visits occurred between 1993 and 1998, then annually until the trials ended in 2002 through 2005; medication inventories were obtained at baseline and years 1, 3, 6, and 9.
Use at the first Women's Health Initiative visit after a coronary heart disease diagnosis increased over time for statins (49% to 72%;
P < .0001), beta-blockers (49% to 62%;
P = .003), and angiotensin-converting enzyme inhibitors/angiotensin-II receptor blockers (ACEI/ARBs; 26%-43%;
P < .0001). Aspirin use remained stable at 76% (
P = .09). Once women reported using a statin, aspirin, or beta-blocker, 84% to 89% reported use at 1 or more subsequent visits, with slightly lower rates for ACEI/ARBS (76%). Statin, aspirin, beta-blocker, or ACEI/ARB use was reported at 2 or more consecutive visits by 57%, 66%, 48%, and 28%, respectively. These drugs were initiated or resumed at a later visit by 24%, 17%, 15%, and 17%, respectively, and were never used during the period of follow-up by 19%, 10%, 33%, and 49% respectively.
Efforts to improve secondary prevention medication use should target both drug initiation and restarting drugs in patients who have discontinued them.
Details
- Title: Subtitle
- Another treatment gap: Restarting secondary prevention medications: The Women's Health Initiative
- Creators
- Jennifer G Robinson - Department of Medicine, 200 Hawkins Drive SE 21C GH, University of Iowa, Iowa City, IA 52242 USARobert Wallace - Department of Epidemiology, 200 Hawkins Drive SE 21C GH, University of Iowa, Iowa City, IA 52242 USAMonika M Safford - Deep South Center on Effectiveness at the Birmingham VA Medical Center and the University of Alabama, Birmingham, AL, USAMary Pettinger - Fred Hutchinson Cancer Center, Seattle, WA, USABarbara Cochrane - University of Washington, Seattle, WA, USAMarcia G Ko - Division of Women's Health, Mayo Clinic, Scottsdale, AZ, USAMary Jo O'Sullivan - University of Miami, Miller School of Medicine, Miami, FL, USAKamal Masaki - Department of Geriatric Medicine, University of Hawaii, Manoa, HIHelen Petrovich - John A. Burns School of Medicine and School of Public Health, University of Hawaii, Manoa, HI; for the Women's Health Initiative Investigators
- Resource Type
- Journal article
- Publication Details
- Journal of clinical lipidology, Vol.4(1), pp.36-45
- DOI
- 10.1016/j.jacl.2009.12.006
- PMID
- 20354566
- PMCID
- PMC2845400
- NLM abbreviation
- J Clin Lipidol
- ISSN
- 1933-2874
- eISSN
- 1876-4789
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 2010
- Academic Unit
- Epidemiology; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9983995112602771
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