Prevalence of statin use in type 2 biabetes mellitus and/or hypertensive patients at risk of coronary heart disease in Shamiya family practice health center-kuwait

ABSTRACT

Hyperlipidemia represents an important risk factor in the development and progression of coronary heart disease. Statin, as a lipid-lowering therapy, is associated with a significant reduction in the risk of primary and secondary cardiovascular events. To determine the prevalence of statin use in patients with type 2 diabetes mellitus, and/or hypertensive patients at high risk of coronary heart disease. The study design was cross sectional descriptive one that was carried out in Shamiya primary health care center-Kuwait. All patients with type 2 diabetes and/or hypertension attended for follow-up during the study period were potentially eligible for the study if their age was cardiovascular disease. Recruitment effort revealed 265 diabetic and 155 hypertensive patients. The study questionnaire included personal characteristics, clinical data, statin use, in addition to biochemical investigations, Framingham risk assessment equation was used to stratify hypertensive patients into low, intermediate and high coronary heart disease risk groups. Patients in intermediate risk group were re-evaluated for indication of statin use by counting the number of risk factors they had. Overall, borderline and high lipid profiles were detected in 44.3%, 88.3%, 78.1% and 33.5% of the studied subjects for total cholesterol, HDL-C, LDL-C and triglycerides respectively. The total number of hypertensive patients in whom statin was recommended was 26 patients [10 high risk category and 16 intermediate risk category]. Statin was used by 45 diabetic patients [17%] and 9 hypertensive patients [34.6%]. It was freely supplied by the government for 59.3% of patients [68.1% of Kuwaiti versus 0.0% for Non-Kuwaiti patients]. Statin was significantly under-used in diabetic and hypertensive patients at risk of coronary heart disease in primary health care. A multidimensional intervention program is necessary to combat barriers to adequate treatment of high-risk patients including patient, physician and health care system