Age and Sex Disparities in Discharge Statin Prescribing in the Stroke Belt: Evidence From the Reasons for Geographic and Racial Differences in Stroke Study
Year: 2017
Type: article
Abstract: Background Stroke is a costly and debilitating disease that disproportionately affects blacks. Despite the efficacy of statins, evidence suggests racial disparities may exist in statin prescribing. Methods and Results We analyzed discharge medications for participants hospitalized for an ischemic stroke during follow‐up of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. Medications on admission and discharge were abstracted from medical records. Among the 666 eligible incident strokes (2003–2013), analyses were restricted to 323 participants who were not statin users at the time of admission and had no history of atrial fibrillation. Overall, 48.7% were prescribed a statin on discharge. In the Stroke Belt, participants aged 65 years and older were 47% less likely to be discharged on a statin compared with those younger than 65 years (relative risk [ RR ], 0.53; 95% CI , 0.38–0.74). This association was not observed in non–Stroke Belt residents. Outside the Stroke Belt, blacks were more likely than whites to be discharged on a statin ( RR , 1.42; 95% CI , 1.04–1.94), while no black:white association was present among Stroke Belt residents ( RR , 0.93; 95% CI , 0.69–1.26; P for interaction=0.228). Compared with women, men in the Stroke Belt were 31% less likely to be discharged on a statin ( RR , 0.69; 95% CI , 0.50–0.94) while men outside the Stroke Belt were more likely to be discharged on a statin ( RR , 1.38; 95% CI , 0.99–1.92; P for interaction=0.004). Conclusions Statin discharge prescribing may differ among Stroke Belt and non–Stroke Belt residents, particularly in older Americans and men.
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,810
Funders: U.S. Department of Health and Human Services, National Institutes of Health, Agency for Healthcare Research and Quality, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Institute on Minority Health and Health Disparities
Awards: VCID and Stroke in a Bi-racial National Cohort, REasons for Geographic And Racial Differences in Stroke- Myocardial Infarction-3, UAB K12 IN PATIENT CENTERED OUTCOMES RESEARCH, G4762432080, UAB HEALTH SERVICES & OUTCOMES RESEARCH TRAINING PROGRAM, Discovery, Implementation and Mentorship in Personalized Cardiovascular Pharmacotherapy, UAB Diabetes Research Center, Deep South Resource Center for Minority Aging Research (RCMAR)
OpenAlex ID: W2742054955