Abstract
Statins are highly effective in managing hypercholesterolaemia in patients with or without chronic heart disease due to extensive evidence for safety, efficacy and cost effectiveness. Observational cross sectional retrospective cohort study was done in approximately 200 primary care practices in Scotland. Frequency, rates and time trends for statin prescriptions together with demographic data and the prescribing patterns for high dose simvastatin and newer statins in its place was measured. 63%, 27%, 5%, 4% and 1% patients were prescribed simvastatin, atorvastatin, pravastatin, rosuvastatin and fluvastatin respectively (n=1,91370). Prevalence for individual statin as well as for all statin prescriptions, significantly increased (p<0.05). Except rosuvastatin the incidence of other statins prescription significantly decreased (p<0.05). The highest number of patients, 884 (24%) switched to atorvastatin from high dose simvastatin. Increase in prevalent use and decrease in incident use of statins, implies the diminished cardiovascular disease related mortality and subsequent increased life expectancy of patients with cardiovascular disease.
Highlights
Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality throughout the world
Using primary care data from the Primary Care Clinical Informatics Unit (PCCIU) database, we assessed patients’ age in years and sex of individual patients prescribed any statin, number of patients prescribed individual statin, percentages of patients prescribed high dose (80 mg) simvastatin and the patients those switched from high dose simvastatin to other statin within the study period
Patients those were prescribed simvastatin and atorvastatin, 48% (57,720) and 49% (25,652) were females respectively with the highest proportion lies in the 7180 years age group, while 52% (62,558) and 51% (26,473) were males with the highest proportion in the 61-70 years group for both the drugs
Summary
Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality throughout the world. Statins are the most used drugs in the UK and other part of the globe for the wide evidence of safety, cost effectiveness, potency in decreasing CHD and stroke risk both in primary and secondary cases (Mason et al, 2009; Mcelduff et al, 2006). The daily dose of 40 mg simvastatin was suggested by NICE as the first-line treatment option for reducing the CVD incidence. Multiple studies have demonstrated the incremental benefits with aggressive statin treatment over moderate statin therapy in high risk patients (Pedersen et al, 2005; Rosa et al, 2005). On the contrary high dose simvastatin (80 mg) may not be suitable for prescribing due to the risk of developing rhabdomyolysis (Lemos et al, 2004; Bruckert et al, 2005; SEARCH, 2010; Davidson et al, 2007)
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