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Age and Sex Disparities in Discharge Statin Prescribing in the Stroke Belt: Evidence From the Reasons for Geographic and Racial Differences in Stroke Study.

TitleAge and Sex Disparities in Discharge Statin Prescribing in the Stroke Belt: Evidence From the Reasons for Geographic and Racial Differences in Stroke Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsAlbright, KC, Howard, VJ, Howard, G, Muntner, P, Bittner, V, Safford, MM, Boehme, AK, J Rhodes, D, T Beasley, M, Judd, SE, McClure, LA, Limdi, N, Blackburn, J
JournalJ Am Heart Assoc
Volume6
Issue8
Date Published2017 Aug 02
ISSN2047-9980
KeywordsAfrican Americans, Age Distribution, Aged, Aged, 80 and over, Atrial Fibrillation, European Continental Ancestry Group, Female, Healthcare Disparities, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Male, Patient Discharge, Prospective Studies, Residence Characteristics, Sex Distribution, Stroke, United States
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; 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; for interaction=0.004).CONCLUSIONS: Statin discharge prescribing may differ among Stroke Belt and non-Stroke Belt residents, particularly in older Americans and men.

DOI10.1161/JAHA.117.005523
Alternate JournalJ Am Heart Assoc
PubMed ID28768644
PubMed Central IDPMC5586419
Grant ListK24 HL133373 / HL / NHLBI NIH HHS / United States
R01 HL080477 / HL / NHLBI NIH HHS / United States