Neutel C Ineke, Morrison Howard, Campbell Norm R C, de Groh Margaret
Centre for Chronic Diseases Prevention and Control, Public Health Agency of Canada, Ottawa, ON.
Can J Public Health. 2007 Sep-Oct;98(5):412-6. doi: 10.1007/BF03405430.
Regular statin use is an important tool in chronic disease management, lowering cholesterol levels and reducing risk of cardiovascular disease (CVD). The objectives of this study are to describe statin use in Canada by comorbidity and lifestyle risk factors, and determine persistence in statin use.
The longitudinal National Population Health Survey, 1994-2002, is a random sample of the 1994 Canadian population and five interviews were conducted at two-year intervals. A total of 8,198 respondents, aged 20 in 1994, completed all five interviews. Information collected included demographic variables, medication use, CVD lifestyle risk factors, CVD, diabetes and hypertension.
Age-adjusted rates of statin use increased from 1.6% to 7.8% over the period 1994-2002. Statin use was higher with increasing age, diabetes, BMI, physician visits, and insurance for prescription medication. Although persons with CVD were more likely to take statins than those without, by 2002 still only 32.7% of heart patients were taking statins. Statin use did not increase linearly with increasing numbers of CVD risk factors or comorbidities. Of the 441 persons reporting statin use in 2000, 74.6% were still taking them in 2002. People who completed their high school education were more likely to continue taking statins than those who did not complete high school.
While statin use increased over time, was associated with CVD and diabetes, and to a lesser extent with increased BMI, a substantive underuse in high-risk patients remains. Helping high-risk people to increase statin use continues to be a priority for health care professionals.
长期使用他汀类药物是慢性病管理的一项重要手段，可降低胆固醇水平并降低心血管疾病（CVD）风险。本研究的目的是按合并症和生活方式风险因素描述加拿大的他汀类药物使用情况，并确定他汀类药物使用的持续性。
1994 - 2002年的纵向全国人口健康调查是对1994年加拿大人口的随机抽样，每两年进行一次共五次访谈。共有8198名1994年年龄为20岁的受访者完成了所有五次访谈。收集的信息包括人口统计学变量、药物使用情况、心血管疾病生活方式风险因素、心血管疾病、糖尿病和高血压。
在1994 - 2002年期间，年龄调整后的他汀类药物使用率从1.6%增至7.8%。他汀类药物的使用随着年龄增长、患糖尿病、体重指数（BMI）增加、看医生次数以及有处方药保险而增多。虽然患有心血管疾病的人比未患心血管疾病的人更有可能服用他汀类药物，但到2002年，仍只有32.7%的心脏病患者在服用他汀类药物。他汀类药物的使用并非随着心血管疾病风险因素或合并症数量的增加而呈线性增加。在2000年报告使用他汀类药物的441人中，74.6%在2002年仍在服用。完成高中学业的人比未完成高中学业的人更有可能继续服用他汀类药物。
虽然他汀类药物的使用随时间增加，与心血管疾病和糖尿病相关，且在较小程度上与体重指数增加相关，但高危患者的使用仍严重不足。帮助高危人群增加他汀类药物的使用仍然是医疗保健专业人员的一项优先任务。
