To the Editor: The efficacy of evidence‐based doses of statins is well established. The poor compliance with high intensity lipid‐lowering pharmacotherapy reported by Brieger and colleagues1 in the CONCORDANCE study has been noted in many studies.2 Compliance is related to several factors, including patients’ perspectives and concerns about quality of life and possible adverse effects3 compared with potential benefits.
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- 1. Brieger D, D'Souza M, Huyn K, et al. Intensive lipid‐lowering therapy in the 12 months after an acute coronary syndrome in Australia: an observational analysis. Med J Aust 2019; 210: 80–85. https://www.mja.com.au/journal/2019/210/2/intensive-lipid-lowering-therapy-12-months-after-acute-coronary-syndrome
- 2. Maningat P, Gordon BR, Breslow JL. How do we improve patient compliance and adherence to long‐term statin therapy? Curr Atheroscler Rep 2013; 15: 291–301.
- 3. Roose SP. Compliance: the impact of adverse events and tolerability on the physician's treatment decisions. Eur Neuropsychoparmacol 2003; 13 (Suppl): S85–S92.
- 4. Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014; 129 (Suppl): S1–S45.
- 5. Nordmann A, Schwartz G, Vale N, et al. Cochrane corner: early statin therapy in acute coronary syndromes — what clinical benefit? Heart 2016; 102: 653–654.
- 6. Dimmitt SB, Stampfer HG, Warren JB. The pharmacodynamic and clinical trial evidence for statin dose. Br J Clin Pharmacol 2018; 84: 1128–1135.
- 7. Simvastatin over the counter. Drug Ther Bull 2005; 43: 25–28.
- 8. Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group. Intensive lowering of LDL cholesterol with 80 mg versus 20 mg simvastatin daily in 12 064 survivors of myocardial infarction: a double‐blind randomised trial. Lancet 2010; 376: 1658–1669.
- 9. de Lemos JA, Blazing MA, Wiviott SD, et al. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: phase Z of the A to Z trial. JAMA 2004; 292: 1307–1316.
- 10. LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005; 352: 1425–1435.
- 11. Pedersen TR, Faergeman O, Kastelein JJ, et al. High‐dose atorvastatin vs usual‐dose simvastatin for secondary prevention after myocardial infarction the IDEAL study: a randomized controlled trial. JAMA 2005; 294: 2437–2445.
- 12. Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004; 350: 1495–1504.
- 13. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta‐analysis. BMJ 2003; 326: 1423.
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