Statin use in primary prevention of cardiovascular diseases among an urban Sri Lankan cohort of patients with cardiovascular risk factors

Abstract

BACKGROUND: Guidelines on statin prescription for primary prevention of cardiovascular diseases (CVD) have changed. However, there is limited data on use of statin in primary prevention among Sri Lankans. OBJECTIVES: We aimed to describe statin use in primary prevention of CVD in relation to 2018 AHA guidelines among an urban Sri Lankan cohort of patients with cardiovascular risk factors. METHODS: All patients without previous CVD but having vascular risk factors attending a follow-up medical clinic of a community surveys of urban Sri Lanka were studied from March 2018-2019. Data were collected using an interviewer administered questionnaire. Patients' 10-year CV risk was calculated using WHO/ISH charts (SEAR B). LDL targets were defined as <70 mg/dl - high risk, <100 mg/dl - intermediate risk and <130mg/dl - low risk patients on AACE 2017 Guidelines. Data were analysed using SPSS-version22. RESULTS: Total of 170 subjects (mean age 66.0±6.70years) were studied and of them 137(80.6%) were females. 129(75.9%), 26(15.3%), 15(8.8%) were at low, intermediate and high risk of CVD respectively. Prevalence of CV risk factors; diabetes mellitus, hypertension and smoking were 80 (47.1%), 114(67.5%), 4(2.4%) respectively. 152(89.4%) were on statins and 110(72.4%) had LDL controlled to target. 87% (70) of diabetics were on statins and 68%.,48) had LDL <lOOmg/dl and 61%(43) had LDL <70mg/dl. Over 93% (14) high CVD risk patients were on statins but only 7% (1) of them had LDL <70 mg/dl. All patients with LDL> 190mg/dl were on statins. CONCLUSIONS: Even though statin prescription in primary prevention is satisfactory, a significant proportion has not met the treatment goals in this Sri Lank.an cohort.