Limited data are available on the prevalence and correlates of statin use for secondary cardiovascular (CV) prevention in the older adult population. We used data of older adults (65–79 years) with established atherosclerotic CV disease from the cross-sectional Italian Health Examination Survey 2008–2012 to address this issue. Lifestyles, CV risk factors, chronic diseases, and therapies were assessed using standardized procedures. A comprehensive geriatric assessment was performed to evaluate cognitive function, disability in basic activities of daily living/instrumental activities of daily living, mobility, and polypharmacy. Multiple regression analyses were performed to identify independent correlates of statin use. A total of 392 participants (mean age 72.1 ± 4.4 years, 61.5% men) were considered for this analysis. Coronary heart disease was identified in 67.1% of participants, cerebrovascular disease in 23.5%, and peripheral artery disease (PAD) in 18.1%. One hundred ninety (48.5%) were statin users. By multiple regression analysis, functional disability (odds ratio [OR] = 0.81; 95% confidence interval [CI] = 0.71–0.92; p = 0.002), cognitive impairment (OR = 0.87; 95% CI = 0.78–0.98; p = 0.018), and polypharmacy (OR = 0.86; 95% CI = 0.75–0.98; p = 0.035) predicted statin nonuse, whereas having hypertension (OR = 1.19; 95% CI = 1.05–1.34; p = 0.005), diabetes mellitus (OR = 1.14; 95% CI = 1.03–1.27; p = 0.013), or a previous myocardial revascularization (OR = 1.31; 95% CI = 1.16–1.48; p < 0.001) predicted statin use. Significant interaction terms were observed between cerebrovascular disease, PAD, cognitive impairment, and disability in predicting statin nonuse. Statin underuse in older adults aged 65–79 years with CV disease, and thus suboptimal secondary CV prevention, is highly prevalent despite current guidelines and recommendations. Common geriatric conditions are associated with statin nonuse. Such results support the need for improving the awareness of statin treatment for secondary CV prevention.

中文翻译：

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65-79 岁老年人心血管疾病二级预防中他汀类药物使用不足的流行率和相关性。2008-2012 年意大利健康检查调查。

关于老年人群中他汀类药物用于二级心血管 (CV) 预防的流行率和相关性的可用数据有限。我们使用 2008-2012 年横断面意大利健康检查调查中患有动脉粥样硬化 CV 疾病的老年人（65-79 岁）的数据来解决这个问题。生活方式、心血管风险因素、慢性病和治疗方法使用标准化程序进行评估。进行了全面的老年评估，以评估认知功能、日常生活基本活动/日常生活的工具性活动、活动能力和多药性的残疾。进行多元回归分析以确定他汀类药物使用的独立相关性。共有 392 名参与者（平均年龄 72.1 ± 4.4 岁，男性占 61.5%）被考虑用于此分析。67.1% 的参与者被发现患有冠心病，23.5% 的参与者患有脑血管疾病，18.1% 的参与者患有外周动脉疾病 (PAD)。190 人 (48.5%) 是他汀类药物使用者。通过多元回归分析，功能障碍（比值比 [OR] = 0.81；95% 置信区间 [CI] = 0.71–0.92；p  = 0.002）、认知障碍（OR = 0.87；95% CI = 0.78–0.98；p  = 0.018）和多重用药（OR = 0.86；95% CI = 0.75–0.98；p  = 0.035）预测他汀类药物不使用，而有高血压（OR = 1.19；95% CI = 1.05–1.34；p  = 0.005）、糖尿病（OR = 1.14；95% CI = 1.03–1.27；p  = 0.013）或之前的心肌血运重建（OR = 1.31；9） % CI = 1.16–1.48；p < 0.001) 预测他汀类药物的使用。在预测他汀类药物不使用方面，在脑血管疾病、PAD、认知障碍和残疾之间观察到显着的相互作用项。尽管有当前的指南和建议，但他汀类药物在患有心血管疾病的 65-79 岁老年人中使用不足，从而导致心血管二级预防不理想，这种情况非常普遍。常见的老年病与不使用他汀类药物有关。这样的结果支持需要提高他汀类药物治疗对心血管二级预防的认识。