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Somatic symptoms of anxiety and nonadherence to statin therapy

Korhonen, MJ; Pentti, J; Hartikainen, J; Kivimaeki, M; Vahtera, J; (2016) Somatic symptoms of anxiety and nonadherence to statin therapy. International Journal of Cardiology , 214 pp. 494-500. 10.1016/j.ijcard.2016.04.003. Green open access

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Abstract

BACKGROUND: The association between anxiety and nonadherence to preventive therapies remains unclear. We investigated whether somatic symptoms of anxiety predict statin nonadherence. METHODS: This is a prospective cohort study of 1924 individuals who responded to a questionnaire survey on health status and initiated statin therapy after the survey during 2008–2010. We followed the cohort for nonadherence, defined as the proportion of days covered < 80%, during the 365 days since the first dispensation after the survey. We used log-binomial regression to estimate the predictors of nonadherence. RESULTS: 18% of participants reported no experience of the eight somatic symptoms of anxiety (palpitation without exercise, irregular heartbeat, chest pain upon anger or emotion, sweating without exercise, flushing, tremor of hands or voice, muscle twitching) before the statin initiation, and 16% had experienced at least one symptom on average weekly to daily. 49% of respondents were nonadherent. Weekly to daily occurrence of these symptoms predicted a 33% increase in the risk of nonadherence (risk ratio [RR] 1.33, 95% confidence interval, CI, 1.13–1.57) compared to no symptoms when adjusted for sociodemographics, lifestyle risks, cardiovascular comorbidities, and depression. Particularly, chest pain upon anger or emotion (RR 1.21, 95% CI 1.01–1.46) and muscle twitching (RR 1.24, 95% CI 1.08–1.42) predicted an increased risk of nonadherence to statin therapy. Psychological symptoms of anxiety were not associated with nonadherence when adjusted for somatic symptoms. CONCLUSIONS: Somatic anxiety-related symptoms predicted nonadherence to statin therapy. Information on pre-existing somatic symptoms may help identifying patients at increased risk of statin nonadherence.

Type: Article
Title: Somatic symptoms of anxiety and nonadherence to statin therapy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.ijcard.2016.04.003
Publisher version: https://doi.org/10.1016/j.ijcard.2016.04.003
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Statins, Medication Adherence, Symptoms, Anxiety, Coronary-Heart-Disease, Middle-Aged Patients, Cardiovascular-Disease, Medication Adherence, Antihypertensive Medication, Primary Prevention, Randomized-Trials, LDL Cholesterol, Low-Risk, Metaanalysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1490290
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