Use of statins and beta-blockers after acute myocardial infarction according to income and education.

Jeppe Nørgaard Rasmussen; Gunnar H Gislason; Søren Rasmussen; Steen Z Abildstrom; Tina K Schramm; Lars Køber; Finn Diderichsen; Merete Osler; Christian Torp-Pedersen; Mette Madsen

doi:10.1136/jech.2006.055525

Use of statins and beta-blockers after acute myocardial infarction according to income and education.

Jeppe Nørgaard Rasmussen, Gunnar H Gislason, Søren Rasmussen, Steen Z Abildstrom, Tina K Schramm, Lars Køber, Finn Diderichsen, Merete Osler, Christian Torp-Pedersen, Mette Madsen

Department of Public Health

56 Citations (Scopus)

Abstract

OBJECTIVE: To study the initiation of and long-term refill persistency with statins and beta-blockers after acute myocardial infarction (AMI) according to income and education. DESIGN AND SETTING: Linkage of individuals through national registers of hospitalisations, drug dispensation, income and education. PARTICIPANTS: 30 078 patients aged 30-74 years surviving first hospitalisation for AMI in Denmark between 1995 and 2001. MAIN OUTCOME MEASURES: Initiation of statin or beta-blocker treatment (out-patient claim of prescriptions within 6 months of discharge) and refill persistency (first break in treatment lasting at least 90 days, and re-initiation of treatment after a break). RESULTS: When simultaneously estimating the effect of income and education on initiation of treatment, the effect of education attenuated and a clear income gradient remained for both drugs. Among patients aged 30-64 years, high income (adjusted hazard ratio (HR) 1.27; 95% confidence interval (CI) 1.19-1.35) and medium income (HR 1.13; 95% CI 1.06-1.20) was associated with initiation of statin treatment compared with low income. The risk of break in statin treatment was lower for patients with high (HR 0.73; 95% CI 0.66-0.82) and medium (HR 0.82; 95% CI 0.74-0.92) income compared with low income, whereas there was a trend in the opposite direction concerning a break in beta-blocker treatment. There was no gradient in re-initiation of treatment. CONCLUSION: Patients with low compared with high income less frequently initiated preventive treatment post-AMI, had worse long-term persistency with statins, but tended to have better persistency with beta-blockers. Low income by itself seems not to be associated with poor long-term refill persistency post-AMI.
Udgivelsesdato: 2007-Dec

Original language	English
Journal	Journal of Epidemiology & Community Health
Volume	61
Issue number	12
Pages (from-to)	1091-7
Number of pages	6
ISSN	0143-005X
DOIs	https://doi.org/10.1136/jech.2006.055525
Publication status	Published - 2007

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10.1136/jech.2006.055525

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@article{ae88fa50ff6311dcbee902004c4f4f50,

title = "Use of statins and beta-blockers after acute myocardial infarction according to income and education.",

abstract = "OBJECTIVE: To study the initiation of and long-term refill persistency with statins and beta-blockers after acute myocardial infarction (AMI) according to income and education. DESIGN AND SETTING: Linkage of individuals through national registers of hospitalisations, drug dispensation, income and education. PARTICIPANTS: 30 078 patients aged 30-74 years surviving first hospitalisation for AMI in Denmark between 1995 and 2001. MAIN OUTCOME MEASURES: Initiation of statin or beta-blocker treatment (out-patient claim of prescriptions within 6 months of discharge) and refill persistency (first break in treatment lasting at least 90 days, and re-initiation of treatment after a break). RESULTS: When simultaneously estimating the effect of income and education on initiation of treatment, the effect of education attenuated and a clear income gradient remained for both drugs. Among patients aged 30-64 years, high income (adjusted hazard ratio (HR) 1.27; 95% confidence interval (CI) 1.19-1.35) and medium income (HR 1.13; 95% CI 1.06-1.20) was associated with initiation of statin treatment compared with low income. The risk of break in statin treatment was lower for patients with high (HR 0.73; 95% CI 0.66-0.82) and medium (HR 0.82; 95% CI 0.74-0.92) income compared with low income, whereas there was a trend in the opposite direction concerning a break in beta-blocker treatment. There was no gradient in re-initiation of treatment. CONCLUSION: Patients with low compared with high income less frequently initiated preventive treatment post-AMI, had worse long-term persistency with statins, but tended to have better persistency with beta-blockers. Low income by itself seems not to be associated with poor long-term refill persistency post-AMI. Udgivelsesdato: 2007-Dec",

author = "Rasmussen, {Jeppe N{\o}rgaard} and Gislason, {Gunnar H} and S{\o}ren Rasmussen and Abildstrom, {Steen Z} and Schramm, {Tina K} and Lars K{\o}ber and Finn Diderichsen and Merete Osler and Christian Torp-Pedersen and Mette Madsen",

year = "2007",

doi = "10.1136/jech.2006.055525",

language = "English",

volume = "61",

pages = "1091--7",

journal = "Journal of Epidemiology & Community Health",

issn = "0143-005X",

publisher = "B M J Group",

number = "12",

}

TY - JOUR

T1 - Use of statins and beta-blockers after acute myocardial infarction according to income and education.

AU - Rasmussen, Jeppe Nørgaard

AU - Gislason, Gunnar H

AU - Rasmussen, Søren

AU - Abildstrom, Steen Z

AU - Schramm, Tina K

AU - Køber, Lars

AU - Diderichsen, Finn

AU - Osler, Merete

AU - Torp-Pedersen, Christian

AU - Madsen, Mette

PY - 2007

Y1 - 2007

N2 - OBJECTIVE: To study the initiation of and long-term refill persistency with statins and beta-blockers after acute myocardial infarction (AMI) according to income and education. DESIGN AND SETTING: Linkage of individuals through national registers of hospitalisations, drug dispensation, income and education. PARTICIPANTS: 30 078 patients aged 30-74 years surviving first hospitalisation for AMI in Denmark between 1995 and 2001. MAIN OUTCOME MEASURES: Initiation of statin or beta-blocker treatment (out-patient claim of prescriptions within 6 months of discharge) and refill persistency (first break in treatment lasting at least 90 days, and re-initiation of treatment after a break). RESULTS: When simultaneously estimating the effect of income and education on initiation of treatment, the effect of education attenuated and a clear income gradient remained for both drugs. Among patients aged 30-64 years, high income (adjusted hazard ratio (HR) 1.27; 95% confidence interval (CI) 1.19-1.35) and medium income (HR 1.13; 95% CI 1.06-1.20) was associated with initiation of statin treatment compared with low income. The risk of break in statin treatment was lower for patients with high (HR 0.73; 95% CI 0.66-0.82) and medium (HR 0.82; 95% CI 0.74-0.92) income compared with low income, whereas there was a trend in the opposite direction concerning a break in beta-blocker treatment. There was no gradient in re-initiation of treatment. CONCLUSION: Patients with low compared with high income less frequently initiated preventive treatment post-AMI, had worse long-term persistency with statins, but tended to have better persistency with beta-blockers. Low income by itself seems not to be associated with poor long-term refill persistency post-AMI. Udgivelsesdato: 2007-Dec

AB - OBJECTIVE: To study the initiation of and long-term refill persistency with statins and beta-blockers after acute myocardial infarction (AMI) according to income and education. DESIGN AND SETTING: Linkage of individuals through national registers of hospitalisations, drug dispensation, income and education. PARTICIPANTS: 30 078 patients aged 30-74 years surviving first hospitalisation for AMI in Denmark between 1995 and 2001. MAIN OUTCOME MEASURES: Initiation of statin or beta-blocker treatment (out-patient claim of prescriptions within 6 months of discharge) and refill persistency (first break in treatment lasting at least 90 days, and re-initiation of treatment after a break). RESULTS: When simultaneously estimating the effect of income and education on initiation of treatment, the effect of education attenuated and a clear income gradient remained for both drugs. Among patients aged 30-64 years, high income (adjusted hazard ratio (HR) 1.27; 95% confidence interval (CI) 1.19-1.35) and medium income (HR 1.13; 95% CI 1.06-1.20) was associated with initiation of statin treatment compared with low income. The risk of break in statin treatment was lower for patients with high (HR 0.73; 95% CI 0.66-0.82) and medium (HR 0.82; 95% CI 0.74-0.92) income compared with low income, whereas there was a trend in the opposite direction concerning a break in beta-blocker treatment. There was no gradient in re-initiation of treatment. CONCLUSION: Patients with low compared with high income less frequently initiated preventive treatment post-AMI, had worse long-term persistency with statins, but tended to have better persistency with beta-blockers. Low income by itself seems not to be associated with poor long-term refill persistency post-AMI. Udgivelsesdato: 2007-Dec

U2 - 10.1136/jech.2006.055525

DO - 10.1136/jech.2006.055525

M3 - Journal article

C2 - 18000133

SN - 0143-005X

VL - 61

SP - 1091

EP - 1097

JO - Journal of Epidemiology & Community Health

JF - Journal of Epidemiology & Community Health

IS - 12

ER -