The Effects of Statins on Primary Prevention for Cardiovascular Diseases among the Elderly

• Main Authors: Wei-Lun Chang, 張瑋倫
• Other Authors: Weng-Foung Huang
• Format: Others
• Language: zh-TW
• Published: 2013
• Online Access: http://ndltd.ncl.edu.tw/handle/13440915954647860381

碩士 === 國立陽明大學 === 衛生福利研究所 === 101 === Background and Objective：Few studies exist on the effectiveness of statins used by the elderly for primary prevention on cardi`ovascular diseases (CVD). This study examined the association between statins with 3 major CVDs--coronary artery heart disease, cerebrovascular disease and peripheral arterial occlusion disease--among the elderly without related medical history. Methods：Year 2000-2003 National Health Insurance Research database was used to conduct a population-based, retrospective cohort study. We identified 5,358 newly lipid-lowering drug users who aged over 55 years and did not have CVD medical history and classified them into three medication groups based on the lipid-lowering drugs prescribed during the study period: (M1) non-statin lipid-lowering drugs; (M2) statins combined with other lipid-lowering drugs; (M3) statins only. Cox proportional hazards models were used to examine the association between the use of statins and the risk of CVD. Propensity score was used to adjust the potential self-selection effect of using statins versus other lipid-lowering drugs on CVD risks. Results：Patients who received statins combined with other lipid-lower drugs (M2 group) at lower significantly risk of CVD than those non-statin users (M1 group) (hazard ratio [HR] 0.73; 95% CI 0.61, 0.87). Statins combined with other lipid-lower drugs (M2 group) had significantly lower hazard of coronary heart disease (HR 0.71; 95% CI 0.56, 0.89) and cerebrovascular disease (HR 0.73; 95% CI 0.54, 0.98) than those who used non-statin lipid-lower drugs (M1 group) only among individuals aged 55-64 years. Conclusion：Compared with non-statin lipid-lowering drugs, statins was effective for primary prevention of coronary heart disease and cerebrovascular disease only among the middle-aged patients, not for the elderly. This evidence is essential for clinical practice and for the concern about health insurance reimbursement.