Abstract 15818: Willingness to Reinitiate Statins by Cardiovascular Disease Risk: Data From the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Introduction: Statins are an effective therapy to reduce cardiovascular disease (CVD) risk. Studies suggest many people who discontinue statins can be successfully re-challenged and continue therapy. It is unclear to what extent individuals are receptive to statin re-challenge. Methods: Among 4,057 REGARDS study participants who reported ever taking a statin, we determined the percentage who discontinued statins and were willing to reinitiate therapy by CVD risk. CVD risk was categorized into 4 mutually exclusive groups: (1) history of myocardial infarction (MI) or stroke; (2) diabetes without a history of MI or stroke; (3) 10-year predicted CVD risk ≥ 7.5% without a history of MI, stroke, or diabetes; and (4) “other” (low CVD risk). Results: Overall, 23.6% of participants reported discontinuing statin therapy; 19.1% of those with a history of MI or stroke, 21.4% of those with diabetes, 25.6% of those with 10-year CVD risk ≥ 7.5%, and 28.0% with low CVD risk. Willingness to reinitiate statins was higher among participants with diabetes, 10-year CVD risk ≥ 7.5%, and low CVD risk, each compared to those with a history of MI or stroke (Table). After multivariable adjustment and compared to participants with a history of MI or stroke, the prevalence ratio (PR) for willingness to reinitiate statins was 1.60 (95% CI: 1.09 - 2.33), 1.52 (95% CI: 1.07 - 2.15), and 1.88 (95% CI: 1.15 - 3.07) for participants with diabetes, 10-year CVD risk ≥ 7.5%, and low CVD risk, respectively. Among those at high CVD risk (i.e., those with a history of MI or stroke, diabetes, or a 10-year CVD risk ≥ 7.5%), discontinuation due to side effects was associated with lower willingness to reinitiate statins [adjusted PR (95% CI): 0.47 (0.38 - 0.59)]. Conclusions: Less than one-third of participants who discontinued statins were willing to reinitiate. Willingness to reinitiate statins was higher among individuals with diabetes, 10-year CVD risk ≥ 7.5%, and low CVD risk, compared to those with a history of MI or stroke.