Uptake of Statins Lacking After Stroke

A new study published by the Journal of the American Heart Association revealed that less than 50% of stroke survivors discharged from a hospital received a prescription for statins to lower their cholesterol levels. While the prescription rate varied by location, sex, age, and race, these findings are significant.

The American Heart Association/American Stroke Association currently recommends that patients who experience an ischemic stroke or transient ischemic attacks receive treatment with statins to reduce the risk of recurrent stroke and other heart events. Statins are the only drug known to reduce the risk of recurrent stroke, according to the study.

Compared with other areas, stroke-related death is more common in the southeast United States—known as the Stroke Belt, which includes Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia.

Prior studies have shown that statin prescriptions are lower in the Stroke Belt and among patients who are black, women, and elderly, the investigators noted.

In the new study, the authors evaluated statin use among patients who experienced an ischemic stroke in and outside of the Stroke Belt.

Included in the study were geographic and health data for 323 patients 45 years and older. The authors used computer-assisted telephone interviews, questionnaires, in-home examination, and medical records.

The authors found that 49% of patients overall received a prescription for statins at the time of hospital discharge; however, the number of prescriptions did increase over the 10-year study period.

In contrast with previous studies, the authors did not find that black patients were less likely to receive a statin prescription. Outside of the Stroke Belt, black patients were found to be more likely to receive statins.

The authors also discovered that patients 65 years and older were 47% less likely to receive statins compared with younger patients in the Stroke Belt.

In the Stroke Belt, men were 31% less likely to receive statins compared with women, while men were 38% more likely than women to receive the drugs overall, according to the study.

“All survivors of ischemic stroke should be evaluated to determine whether they could benefit from a statin, regardless of the patient’s age, race, sex or geographic residence,” said lead study author Karen Albright, PhD, DO, MPH.

These findings show that physicians may not be adhering to beneficial guidelines and may be putting the health of their patients at risk. Physicians in the Stroke Belt should be especially aware of the benefits of statins for patients who experienced a stroke.

“In patients hospitalized for stroke, opportunities exist to improve statin prescribing on discharge,” Dr Albright said.