Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Turku, Finland.
Basic Clin Pharmacol Toxicol. 2013 Sep;113(3):173-8. doi: 10.1111/bcpt.12075. Epub 2013 May 20.
This study based on nationwide comprehensive health registers analysed trends in characteristics of statin users in the whole community-dwelling population of Finland between 1999 and 2008. The annual number of incident users (defined as those purchasing statins for the first time ever) increased 1.6-fold from 50,125 to 78,058 and that of ongoing users (including continuous users and re-initiators) increased 4.6-fold from 114,091 to 521,211. The proportion of incident users without cardiovascular disease (CVD) or diabetes increased from 23.6% to 27.8%, while the proportion of those with diabetes increased from 15.7% to 19.5%. An increasing proportion of ongoing users had diabetes (from 13.8% to 22.8%). The proportion of ongoing users without CVD or diabetes remained below one-fifth; however, their number increased five-fold. Over the study period, there was an obvious shift towards prescribing of higher statin doses both among incident and ongoing users. In conclusion, statin use is expanding to individuals with low cardiovascular risk despite the fact that clinical guidelines emphasize interventions other than pharmacotherapy for this population. At the same time, statin use is increasingly targeted to patients with diabetes, a high-risk group that is likely to benefit from it.
本研究基于全国性综合健康登记系统，分析了 1999 年至 2008 年芬兰全人群中他汀类药物使用者特征的变化趋势。新使用者（定义为首次购买他汀类药物的患者）的年增长率从 50,125 人增加到 78,058 人，增加了 1.6 倍；持续使用者（包括连续使用者和重新使用者）的年增长率从 114,091 人增加到 521,211 人，增加了 4.6 倍。无心血管疾病（CVD）或糖尿病的新使用者比例从 23.6%增加到 27.8%，而糖尿病患者的比例从 15.7%增加到 19.5%。越来越多的持续使用者患有糖尿病（从 13.8%增加到 22.8%）。无 CVD 或糖尿病的持续使用者比例仍低于五分之一，但数量增加了五倍。在研究期间，新使用者和持续使用者的他汀类药物剂量均明显增加。总之，尽管临床指南强调对该人群进行药物以外的干预，但他汀类药物的使用正在向心血管风险较低的个体扩展。与此同时，他汀类药物的使用越来越针对糖尿病患者，这是一个高危人群，可能从中受益。
