Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia.
Epidemiological Modelling Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Cardiovasc Drugs Ther. 2018 Jun;32(3):265-272. doi: 10.1007/s10557-018-6794-x.
Statins have become standard of care in the prevention and treatment of atherosclerotic cardiovascular disease. The objective of this study was to examine the trends in statin use among Australians aged ≥ 65 years for the period 2007-2016.
Data from the Pharmaceutical Benefits Scheme covering a 10% random sample of the Australian population were analysed. The 1-year prevalence and incidence of statin use were determined for each year, as were the percentage of statin dispensations according to statin type or intensity and the percentage of new users prescribed each statin type or intensity. To describe relative changes, age-sex adjusted rate ratios (RRs) and 95% confidence intervals (CIs) were determined via Poisson regression modelling using 2007 as the reference year.
The 1-year prevalence of statin use increased consistently each year from 34.2% in 2007 to 44.1% in 2016 (RR 1.29, 95% CI 1.28-1.31). The 1-year incidence was 68.5 per 1000 in 2007 and 59.0 per 1000 in 2016 (RR 0.87, 95% CI 0.84-0.90). Women were 18% (age-adjusted rate ratio [aRR] 0.82, 95% CI 0.79-0.83) less likely than men to initiate statins across all years. The incidence of statin use was also highest among individuals aged 65-74 years, who were about 15% (sex-adjusted rate ratio [sRR] 1.15, 95% CI 1.13-1.16) and 45% (sRR 1.45, 95% CI 1.44-1.47) more likely to initiate statins than those aged 75-84 and ≥ 85 years, respectively. Atorvastatin was the most commonly dispensed statin across all years. The proportion of new users dispensed high-intensity statins increased year-on-year from 23.6% in 2007 to 30.5% in 2016 (RR 1.26, 95% CI 1.21-1.31).
The proportion of older adults in Australia using statins has increased over the last decade, although the incidence has declined. Atorvastatin is the most commonly dispensed statin and the use of high intensity statin has increased.
他汀类药物已成为防治动脉粥样硬化性心血管疾病的标准治疗方法。本研究旨在考察 2007-2016 年期间澳大利亚≥65 岁老年人使用他汀类药物的趋势。
对澳大利亚人群的 10%随机样本进行了药物福利计划数据的分析。确定了每年他汀类药物的使用 1 年患病率和发病率，以及根据他汀类药物类型或强度开具的他汀类药物处方的百分比，以及新使用每种他汀类药物类型或强度的患者的百分比。通过泊松回归模型，使用 2007 年作为参考年，确定了年龄性别调整率比（RR）及其 95%置信区间（CI）。
他汀类药物的 1 年使用率逐年稳步上升，从 2007 年的 34.2%上升至 2016 年的 44.1%（RR 1.29，95%CI 1.28-1.31）。2007 年的 1 年发病率为每 1000 人 68.5 例，而 2016 年为每 1000 人 59.0 例（RR 0.87，95%CI 0.84-0.90）。与男性相比，所有年份女性开始使用他汀类药物的可能性都低 18%（年龄调整率比[aRR]0.82，95%CI 0.79-0.83）。他汀类药物使用率最高的人群是 65-74 岁年龄组，他们开始使用他汀类药物的可能性分别比 75-84 岁和≥85 岁年龄组高 15%（性别调整率比[sRR]1.15，95%CI 1.13-1.16）和 45%（sRR 1.45，95%CI 1.44-1.47）。阿托伐他汀是所有年份中最常用的他汀类药物。高剂量他汀类药物新使用者的比例逐年增加，从 2007 年的 23.6%增加到 2016 年的 30.5%（RR 1.26，95%CI 1.21-1.31）。
过去十年中，澳大利亚使用他汀类药物的老年人比例有所增加，尽管发病率有所下降。阿托伐他汀是最常用的他汀类药物，高强度他汀类药物的使用有所增加。
