Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women with PAD and ICVD

Dhruv Mahtta, Sarah T. Ahmed, David J. Ramsey, Julia M. Akeroyd, Michelle T. Lee, Fatima Rodriguez, Erin D. Michos, Dipti Itchhaporia, Khurram Nasir, Mahboob Alam, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Purpose: This study sought to investigate gender-based disparities in statin prescription rates and adherence among patients with peripheral arterial disease (PAD) and ischemic cerebrovascular disease (ICVD). Methods: We identified patients with PAD or ICVD seeking primary care between 2013 and 2014 in the VA healthcare system. We assessed any statin use, high-intensity statin (HIS) use, and statin adherence among women with PAD or ICVD compared with men. We also compared proportion of days covered (PDC) as a measure of statin adherence; PDC ≥ 0.8 deemed a patient statin adherent. Association between statin use (or adherence) and odds of death or myocardial infarction (MI) at 12-month follow-up was also ascertained. Results: Our analyses included 192,219 males and 3188 females with PAD and 331,352 males and 10,490 females with ICVD. Women with PAD had lower prescription rates of any statin (68.5% vs. 78.7%, OR 0.68, 95% confidence interval (CI) 0.62–0.75), HIS (21.1% vs. 23.7%, OR 0.88, 95% CI 0.79–0.97), and lower statin adherence (PDC ≥ 0.8: 34.6% vs. 45.5%, OR 0.75, 95% CI 0.69–0.82) compared with men. Similar disparities were seen in ICVD patients. Among female patients with PAD or ICVD, statin adherence was associated with lower odds of MI (OR 0.76, 95% CI 0.59–0.98), while use of any statin (OR 0.71, 95% CI 0.56–0.91) and HIS (OR 0.68, 95% CI 0.48–0.97) was associated with lower odds of death at 12 months. Conclusions: Women with PAD or ICVD had lower odds of receiving any statins, HIS, or being statin adherent. Targeted clinician- and patient-level interventions are needed to study and address these disparities among patients with PAD and ICVD.

Original languageEnglish
Pages (from-to)745-754
Number of pages10
JournalCardiovascular Drugs and Therapy
Issue number6
Publication statusPublished - Dec 2020
Externally publishedYes


  • Adherence
  • Gender disparities
  • ICVD
  • PAD
  • Prescription rates
  • Statin


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