People who are obese or former smokers more likely to follow recommended statin therapy

A new study suggests that lifestyle factors can help predict whether people will adhere to statin therapy for high cholesterol. Among people without heart disease and diabetes, those who are overweight, obese or former smokers are more likely to adhere to statin therapy, according to an article in CMAJ (Canadian Medical Association Journal).

Almost 1 in 10 cardiovascular events can be linked to nonadherence to prescribed medication. Studies indicate that nonadherence with statin therapy can be as high as 46%.

To determine whether lifestyle influences statin adherence, researchers looked at data on 11 949 people involved in the Finnish Public Sector Study who had started statin therapy after the survey, between 1998 and 2010. Of these, 928 responded to a survey about health status and lifestyle factors. Nonadherence to statin medication was more common in women, younger people (24 to 50 years old) and single people. People who did not have cardiovascular disease, obesity, overweight or a history of smoking - that is, people in decent health - were less likely to take statins as directed.

"As expected, patients with a history of cardiovascular disease or diabetes had better adherence to statin therapy than those without these comorbidities," writes Dr. Heli Halava, Departments of Public Health and Pharmacology, University of Turku, Turku, Finland, with coauthors. "Because of their increased risk of cardiovascular events, patients with comorbidities likely have a strong perception of the need for statin treatment."

People with cardiovascular comorbidities, heavy drinkers and extreme drinkers (people who passed out from alcohol consumption) were substantially more likely to be nonadherent than nondrinkers.

"Heavy drinkers may intentionally avoid taking mediation because of potential drug-alcohol interactions, they may unintentionally miss doses or even refills because of intoxication, or they may simply be less concerned about missing doses," write the authors.

The finding that people with weight issues and a history of smoking are more likely to follow the recommended therapy can provide valuable insights about how people will take preventive medications.