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Open Access Research article

Lipid-lowering pharmacotherapy and socioeconomic status: atherosclerosis risk in communities (ARIC) surveillance study

Joseph P Kitzmiller1, Randi E Foraker2 and Kathy M Rose34*

Author Affiliations

1 Departments of Pharmacology and Biomedical Engineering, The Ohio State University Medical Center, 5072B Graves Hall 333 West 10th Avenue, Columbus, OH, 43210, USA

2 Division of Epidemiology, College of Public Health, The Ohio State University, 334 Cunz Hall, 1841 Neil Avenue, Columbus, OH, 43230, USA

3 Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Drive, Chapel Hill, NC, 27599, USA

4 SRA International, Inc, 2605 Meridian Parkway, Durham, NC, 27713, USA

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BMC Public Health 2013, 13:488  doi:10.1186/1471-2458-13-488

Published: 20 May 2013

Abstract

Background

Lipid-reduction pharmacotherapy is often employed to reduce morbidity and mortality risk for patients with dyslipidemia or established cardiovascular disease. Associations between socioeconomic factors and the prescribing and use of lipid-lowering agents have been reported in several developed countries.

Methods

We evaluated the association of census tract-level neighborhood household income (nINC) and lipid-lowering medications received during hospitalization or at discharge among 3,546 (5,335 weighted) myocardial infarction (MI) events in the United States (US) Atherosclerosis Risk In Communities (ARIC) surveillance study (1999–2002). Models included neighborhood household income, race, gender, age, study community, year of MI, hospital type (teaching vs. nonteaching), current or past history of hypertension, diabetes or heart failure, and presence of cardiac pain.

Results

About fifty-nine percent of patients received lipid-lowering pharmacotherapy during hospitalization or at discharge. Low nINC was associated with a lower likelihood (prevalence ratio 0.89, 95% confidence interval: 0.79, 1.01) of receiving lipid-lowering pharmacotherapy compared to high neighborhood household income, and no significant change in this association resulted when adjusted for the above-mentioned covariates.

Conclusion

Patient’s socioeconomic status appeared to influence whether they were prescribed a lipid-lowering pharmacotherapy after hospitalization for myocardial infarction in the US ARIC surveillance study (1999–2002).

Keywords:
Lipids; Socioeconomics; Statins; Lipid-lowering pharmacotherapy; Cardiovascular disease