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Cardioprotective medication use and risk factor control among US adults with unrecognized myocardial infarction: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

Levitan EB, Gamboa C, Safford MM, Rizk DV, Brown TM, Soliman EZ, Muntner P - Vasc Health Risk Manag (2013)

Bottom Line: Blood pressure control (,140/90 mmHg) was similar between RMI and UMI groups (prevalence ratio = 1.03, 95% confidence interval 0.93-1.13).Although participants with UMI were somewhat more likely to use cardioprotective medications than those with no MI, they were less likely to use cardioprotective medications and to have controlled low-density lipoprotein cholesterol than participants with RMI.Increasing appropriate treatment and risk factor control among individuals with UMI may reduce risk of mortality and future cardiovascular events.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA. elevitan@uab.edu

ABSTRACT

Background: Individuals with unrecognized myocardial infarction (UMI) have similar risks for cardiovascular events and mortality as those with recognized myocardial infarction (RMI). The prevalence of cardioprotective medication use and blood pressure and low-density lipoprotein cholesterol control among individuals with UMI is unknown.

Methods: Participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who were recruited between May 2004 and October 2007 received baseline twelve-lead electrocardiograms (n = 21,036). Myocardial infarction (MI) status was characterized as no MI, UMI (electrocardiogram abnormalities consistent with MI without self-reported history; n = 949; 4.5%), and RMI (self-reported history of MI; n = 1574; 7.5%).

Results: For participants with no MI, UMI, and RMI, prevalence of use was 38.4%, 44.4%, and 75.7% for aspirin; 18.0%, 25.8%, and 57.2% for beta blockers; 31.7%, 38.7%, and 55.0% for angiotensin converting enzyme inhibitors or angiotensin receptor blockers; and 28.1%, 33.9%, and 64.1% for statins, respectively. Participants with RMI were 35% more likely to have low-density lipoprotein cholesterol < 100 mg/dL than participants with UMI (prevalence ratio = 1.35, 95% confidence interval 1.19-1.52). Blood pressure control (,140/90 mmHg) was similar between RMI and UMI groups (prevalence ratio = 1.03, 95% confidence interval 0.93-1.13).

Conclusion: Although participants with UMI were somewhat more likely to use cardioprotective medications than those with no MI, they were less likely to use cardioprotective medications and to have controlled low-density lipoprotein cholesterol than participants with RMI. Increasing appropriate treatment and risk factor control among individuals with UMI may reduce risk of mortality and future cardiovascular events.

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Related in: MedlinePlus

Predictors of medication use among 949 participants with unrecognized myocardial infarction.Note: Prevalence ratios (circles) and 95% confidence intervals (lines) are adjusted for age, race, and sex
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f2-vhrm-9-047: Predictors of medication use among 949 participants with unrecognized myocardial infarction.Note: Prevalence ratios (circles) and 95% confidence intervals (lines) are adjusted for age, race, and sex

Mentions: Among participants with UMI, older participants and those with diabetes were more likely to be taking all four medications in age-, race-, and sex-adjusted models (Figure 2). Black participants were more likely to take ACEI/ARBs and less likely to take aspirin. Women were also less likely to take aspirin. Education was inversely associated with aspirin, and participants with a regular source of medical care were more likely to take ACEI/ARBs and statins. When the potential correlates of medication use were included in the model simultaneously, the associations were similar. However, the associations of race with ACEI/ARB use, education with aspirin use, and regular source of medical care with ACEI/ARBs were no longer statistically significant (not shown).


Cardioprotective medication use and risk factor control among US adults with unrecognized myocardial infarction: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

Levitan EB, Gamboa C, Safford MM, Rizk DV, Brown TM, Soliman EZ, Muntner P - Vasc Health Risk Manag (2013)

Predictors of medication use among 949 participants with unrecognized myocardial infarction.Note: Prevalence ratios (circles) and 95% confidence intervals (lines) are adjusted for age, race, and sex
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3569379&req=5

f2-vhrm-9-047: Predictors of medication use among 949 participants with unrecognized myocardial infarction.Note: Prevalence ratios (circles) and 95% confidence intervals (lines) are adjusted for age, race, and sex
Mentions: Among participants with UMI, older participants and those with diabetes were more likely to be taking all four medications in age-, race-, and sex-adjusted models (Figure 2). Black participants were more likely to take ACEI/ARBs and less likely to take aspirin. Women were also less likely to take aspirin. Education was inversely associated with aspirin, and participants with a regular source of medical care were more likely to take ACEI/ARBs and statins. When the potential correlates of medication use were included in the model simultaneously, the associations were similar. However, the associations of race with ACEI/ARB use, education with aspirin use, and regular source of medical care with ACEI/ARBs were no longer statistically significant (not shown).

Bottom Line: Blood pressure control (,140/90 mmHg) was similar between RMI and UMI groups (prevalence ratio = 1.03, 95% confidence interval 0.93-1.13).Although participants with UMI were somewhat more likely to use cardioprotective medications than those with no MI, they were less likely to use cardioprotective medications and to have controlled low-density lipoprotein cholesterol than participants with RMI.Increasing appropriate treatment and risk factor control among individuals with UMI may reduce risk of mortality and future cardiovascular events.

View Article: PubMed Central - PubMed

Affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA. elevitan@uab.edu

ABSTRACT

Background: Individuals with unrecognized myocardial infarction (UMI) have similar risks for cardiovascular events and mortality as those with recognized myocardial infarction (RMI). The prevalence of cardioprotective medication use and blood pressure and low-density lipoprotein cholesterol control among individuals with UMI is unknown.

Methods: Participants from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who were recruited between May 2004 and October 2007 received baseline twelve-lead electrocardiograms (n = 21,036). Myocardial infarction (MI) status was characterized as no MI, UMI (electrocardiogram abnormalities consistent with MI without self-reported history; n = 949; 4.5%), and RMI (self-reported history of MI; n = 1574; 7.5%).

Results: For participants with no MI, UMI, and RMI, prevalence of use was 38.4%, 44.4%, and 75.7% for aspirin; 18.0%, 25.8%, and 57.2% for beta blockers; 31.7%, 38.7%, and 55.0% for angiotensin converting enzyme inhibitors or angiotensin receptor blockers; and 28.1%, 33.9%, and 64.1% for statins, respectively. Participants with RMI were 35% more likely to have low-density lipoprotein cholesterol < 100 mg/dL than participants with UMI (prevalence ratio = 1.35, 95% confidence interval 1.19-1.52). Blood pressure control (,140/90 mmHg) was similar between RMI and UMI groups (prevalence ratio = 1.03, 95% confidence interval 0.93-1.13).

Conclusion: Although participants with UMI were somewhat more likely to use cardioprotective medications than those with no MI, they were less likely to use cardioprotective medications and to have controlled low-density lipoprotein cholesterol than participants with RMI. Increasing appropriate treatment and risk factor control among individuals with UMI may reduce risk of mortality and future cardiovascular events.

Show MeSH
Related in: MedlinePlus