Ex-Smokers and the Obese More Likely to Take Prescribed Statins

Risky behaviors among those with heart issues linked to higher likelihood of statin nonadherence

(RxWiki News) Some research has shown that those who regularly drink or smoke are less likely to take their cholesterol medications. But people with a different unhealthy lifestyle factor do seem to take the medications meant to lower cholesterol and improve their health.

A recent study found that overweight or obese people regularly took their statin (cholesterol-lowering) medications. Former smokers were also likely to take their statins as prescribed.

"Take all of your medication as prescribed."

This study was led by Heli Halava, MD, of the Department of Public Health at the University of Turku in Finland.

Dr. Halava and colleagues used data from the Finnish Public Sector Study, which included public sector employees from 10 municipalities. There were 9,285 participants who started on statin therapy between January 1998 and December 31, 2010. All had not taken statins in the previous two years.

Follow-up information was available on participants until the end of 2011.

The study authors checked for adherence to the prescribed statins for the first year after starting on the medication. They also assessed lifestyle behaviors using standard questionnaires.

The investigators assessed body mass index (BMI), a measure of body fat, using self-reported weight and height. They asked questions about smoking, drinking, physical activity and alcohol use.

They also asked about heart diseases, such as chronic high blood pressure, irregular heart beats and coronary artery disease, and about diabetes. There were 6,458 participants with at least one heart issue. The remaining 2,827 participants did not have any known heart disease.

These researchers found that people with known heart disease who had risky drinking behavior, such as having passed out at least once due to drinking, or who had several risky behaviors, such as smoking and being sedentary, were often those who were non-adherent (took less than 80 percent of the medication prescribed).

Among people without any known heart disease or diabetes, those who had previously smoked and those who were overweight or obese were most likely to take their medication as prescribed.

The researchers wrote that that their findings support the idea that people who adhere to long-term medication therapy follow a healthier lifestyle.

Sarah Samaan, MD, is a cardiologist at The Baylor Heart Hospital, located in Plano, Texas. She said that she “would expect that former smokers are more apt to take their medications because they are more likely to be aware of their risk for heart disease. They may also understand and take to heart the fact that the choices they make can make a difference to their health, for better or worse.”

However, Dr. Samaan said that when it comes to the overweight and obese being compliant, the explanation for their compliance is a bit less clear.

“Perhaps they realize that while weight loss can be difficult and may require some sacrifice, cholesterol is one risk factor that they can take charge of without too much difficulty," she said. "Many people who carry extra weight are well aware that they put themselves at risk for heart disease, stroke, hypertension and diabetes, but changing lifestyle and lifelong habits can be very difficult and fraught with emotional and social complications. By contrast, taking a pill is pretty straightforward.”

Dr. Samaan added that it may even be possible that physicians are more inclined to tell their heavier patients to take their medication.

This study was published June 23 in the Canadian Medical Association Journal (CMAJ).

The authors disclosed no conflicts of interest.

Review Date: 
June 22, 2014