Patients with side-effects were more than three times more likely to miss the cholesterol target than those without side-effects – pushing them slightly ahead of patients who did not take their statins, who were three times more likely to miss targets than those who took the treatment, according to research.
The study, conducted by the University of Oslo and published in the European Journal of Preventive Cardiology, assessed over 1,000 patients hospitalised with a first or recurrent coronary event.
Researchers collected sociodemographic, medical and psychosocial information from medical records, a self-report questionnaire, clinical examinations and blood samples while patients were in hospital and at follow-up after two to 36 months.
Over half (57%) of the patients were not meeting their LDL target of 1.8mmol/l at follow-up. Side-effects – mainly muscle complaints – were the biggest cause of missed targets, the results suggest, closely followed by not taking statin treatment.
The researchers also found that patients prescribed moderate or low intensity statins were 62% more likely to miss targets than those prescribed high intensity statins.
Lead author Dr John Munkhaugen said: ‘Patients who experience side-effects are probably more likely to reduce or terminate statin use, or their doctor may prescribe a weaker drug or take them off statins altogether.
‘Individual variations in how the body reacts to and uses the drug may also play a role. Surprisingly, low socioeconomic status and psychosocial factors did not predict failure to control LDL cholesterol.
‘The findings show that the focus for interventions to improve LDL cholesterol control are statin side-effects, and adherence to and prescription of sufficiently potent statins.’