Nonacceptance of Statin Recommendation Common, Especially for Women

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Nonacceptance of statin therapy associated with longer time to achieve LDL cholesterol of less than 100 mg/dL

By Elana Gotkine HealthDay Reporter

TUESDAY, Feb. 28, 2023 (HealthDay News) — For patients at high cardiovascular risk, nonacceptance of a statin therapy recommendation is common, especially among women, according to a study published online Feb. 28 in JAMA Network Open.

C. Justin Brown, Pharm.D., from Brigham and Women’s Hospital in Boston, and colleagues examined sex disparities in nonacceptance of statin therapy in a retrospective cohort study involving statin-naive patients with atherosclerotic cardiovascular disease, diabetes, or low-density lipoprotein (LDL) cholesterol levels of 190 mg/dL or more treated between Jan. 1, 2000, and Dec. 31, 2018.

The researchers found that 21.9 percent of the 24,212 study patients (50.8 percent women) did not accept the initial recommendation of statin therapy. Nonacceptance was more common among women than men (24.1 versus 19.7 percent) and was similarly high in all subgroups stratified by comorbidities. Female sex was associated with lower odds of statin therapy acceptance in a multivariable analysis (odds ratio, 0.82). An LDL cholesterol level of less than 100 mg/dL was achieved during a median of 1.5 versus 4.4 years by those who did versus did not accept a statin therapy recommendation. Nonacceptance of statin therapy was associated with longer time to achieve an LDL cholesterol level less than 100 mg/dL in a multivariable analysis adjusted for demographic characteristics and comorbidities (hazard ratio, 0.57).

“Further research is needed to identify the reasons why patients do not accept statin therapy recommendations and the reasons for the higher rates of this important clinical phenomenon among women,” the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.

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