Statins prescribed to less than 50% of stroke patients across the US, says study

A new research published in the Open Access Journal of the American Heart Association/American Stroke Association - Journal of the American Heart Association - suggests that, prescriptions for statins, a type of cholesterol-lowering medication, are received by less than a half of the stroke patients discharged from the hospital across the nation. The probability of the prescription, also differs by the geographic location, age, sex, as well as race of the patients.

Statin therapy is recommended by the American Heart Association/American Stroke Association for patients who have undergone ischemic stroke or mini-stroke (transient ischemic attacks). It reduces the risk of repeated strokes as well as other cardiovascular events. The only class of cholesterol-lowering drug that is proved to decrease the risk of recurrent stroke is statins.

In southeastern United States, death due to stroke is more common than any other areas. This region –consisting of Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia – is referred as the Stroke Belt. Although, prior researches have shown that among the stroke patients who are discharged from the south as well as blacks, women and elderly patients, the statin prescriptions are lower.

In the new study, in order to evaluate the extent of these variations by age, race and sex, both inside and outside the Stoke belt, the comparison between various groups of patients with ischemic stroke was done.

Demographic and health information which included the risk factors of stroke in 323 stroke patients who were participating in a national study that included over 30,000 U.S. adults aged 45 and older from 2003 to 2013 were evaluated by the researchers. Computer-assisted telephone interviews, questionnaires, an in-home examination, and medical records from the stroke hospitalization and discharge were used.

The results showed that, in total, the prescription for statins was received by 49% of the patients during hospital discharge. Also, a rise in the percentage of patients receiving the prescription was noticed during the course of the 10-year study (61.6 percent in 2003 to 97.8 percent in 2016). As per the Get With The Guidelines, the Stroke database of the American Heart Association/American Stroke Association, quality improvement initiative has helped this rise.

Unlike prior studies, this research did not find the black people were less probable than whites in receiving the drugs. However, it was found that, black patients outside the Stroke Belt were more probable to receive statins when compared to white patients.

Other variations based on age and sex between the residents of the Stroke Belt and non-Stroke belt were also found by the study. It states that black patients, with a 42% probability of receiving statins, were significantly more likely to receive them than white patients.

Karen Albright, Ph.D., D.O., M.P.H., the lead author and advanced fellow in the Geriatric Research, Education and Clinical Center, at the Birmingham VA Medical Center in Birmingham, Alabama said: "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”. According to her, opportunities for improving statin prescription on discharge do exist for stoke patients who are hospitalized.

A few limitations such as the dependency of the study on medical records for statin use and inclusion of patients who were reported as not taking statin while they were admitted to hospitals alone, etc., are expected to affect the result of the study.

• Journal of the American Heart Association Report