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
Emily B Levitan,1 Christopher Gamboa,1 Monika M Safford,2 Dana V Rizk,3 Todd M Brown,4 Elsayed Z Soliman,5 Paul Muntner1
1Department of Epidemiology, 2Division of Preventive Medicine, 3Division of Nephrology, 4Division of Cardiology, University of Alabama at Birmingham, Birmingham, AL, USA; 5Epidemiological Cardiology Research Center, Wake Forest University School of Medicine, Winston Salem, NC, USA
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.
Keywords: unrecognized myocardial infarction, secondary prevention, risk factor control
This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
Readers of this article also read:
Koual M, Abbou H, Carbonnel M, Picone O, Ayoubi JM
Published Date: 15 April 2013
Mahabala C, Kamath P, Bhaskaran U, Pai ND, Pai AU
Published Date: 24 March 2013
Long-term safety and efficacy of telmisartan/amlodipine single pill combination in the treatment of hypertension
Billecke SS, Marcovitz PA
Published Date: 16 March 2013
Takahashi I, Furukawa K, Ohishi W, Takahashi T, Matsumoto M, Fujiwara S
Published Date: 8 March 2013
El-Helou N, Al-Hajje A, Ajrouche R, Awada S, Rachidi S, Zein S, Salameh P
Published Date: 1 March 2013
Lipid management in 13,000 high risk cardiovascular patients treated under daily practice conditions: LIMA Registry
Schaefer JR, Gitt AK, Sonntag F, Weizel A, Jannowitz C, Karmann B, Pittrow D, Bestehorn K
Published Date: 21 February 2013
Comparative effect of clopidogrel plus aspirin and aspirin monotherapy on hematological parameters using propensity score matching
Hayasaka M, Takahashi Y, Nishida Y, Yoshida Y, Hidaka S, Asai S
Published Date: 18 February 2013
Schweizer A, Foley JE, Kothny W, Ahrén B
Published Date: 15 February 2013
Effectiveness of a quality improvement intervention targeting cardiovascular risk factors: are patients responsive to information and encouragement by mail or post?
Senesael E, Borgermans L, Van De Vijver E, Devroey D
Published Date: 13 February 2013
Montgomery JE, Brown JR
Published Date: 29 January 2013