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Underuse of Cardiovascular Medications in Individuals With Known Lower Extremity Peripheral Artery Disease: HCHS/SOL.

TitleUnderuse of Cardiovascular Medications in Individuals With Known Lower Extremity Peripheral Artery Disease: HCHS/SOL.
Publication TypePublication
Year2020
AuthorsHua S, Isasi CR, Kizer JR, Matsushita K, Allison MA, Tarraf W, Qi Q, Ponce SG, Daviglus M, Kaplan RC
JournalJ Am Heart Assoc
Volume9
Issue16
Paginatione015451
Date Published2020 08 18
ISSN2047-9980
KeywordsAcculturation, Adult, Aged, Antihypertensive Agents, Cardiovascular Agents, Comorbidity, Coronary Artery Disease, Health Services Accessibility, Hispanic Americans, Humans, Hypolipidemic Agents, Lower Extremity, Middle Aged, Peripheral Arterial Disease, Platelet Aggregation Inhibitors, regression analysis, Socioeconomic Factors, United States, Young Adult
Abstract

Background Underuse of cardiovascular medications for secondary prevention among individuals with peripheral artery disease (PAD) has been reported. Little is known about PAD treatment status in the Hispanic/Latino population in the United States, who may have limited access to health care and who have worse clinical outcomes than non-Hispanic individuals. Methods and Results We studied the use of cardiovascular therapies in 1244 Hispanic/Latino individuals recruited from 4 sites in the United States, including 826 individuals who reported diagnosis of PAD by physician and 418 individuals with coronary artery disease alone, in the Hispanic Community Health Study/Study of Latinos. We compared the prevalence of using antiplatelet therapy, lipid-lowering therapy and antihypertensive therapy by PAD and coronary artery disease status. Among those with PAD, we studied factors associated with taking cardiovascular medications, including demographic and socioeconomic factors, acculturation, access to health care and comorbidities, using multivariable regression models. The overall prevalence for individuals with PAD taking antiplatelet therapy, lipid-lowering therapy and, among hypertensive individuals, antihypertensive therapy was 31%, 26% and 57%, respectively. Individuals of Mexican background had the lowest use for all classes of cardiovascular medications. Older age, number of doctor visits and existing hypertension and diabetes mellitus were significantly associated with taking cardiovascular therapies in adjusted models. Compared with those with PAD alone, individuals with PAD and concurrent coronary artery disease were 1.52 (95% CI, 1.20-1.93) and 1.74 (1.30-2.32) times more likely to use antiplatelet agents and statins according to multivariable analysis. No significant difference of antihypertensive medication use was found among PAD patients with or without coronary artery disease. Conclusions Hispanic/Latino individuals with known PAD underuse cardiovascular medications recommended in clinical guidelines. More efforts should be directed to improve treatment in this important group.

DOI10.1161/JAHA.119.015451
Alternate JournalJ Am Heart Assoc
PubMed ID32752978
PubMed Central IDPMC7660818
Grant ListN01 HC065233 / HC / NHLBI NIH HHS / United States
N01 HC065234 / HC / NHLBI NIH HHS / United States
N01 HC065235 / HC / NHLBI NIH HHS / United States
N01 HC065236 / HC / NHLBI NIH HHS / United States
N01 HC065237 / HC / NHLBI NIH HHS / United States
MS#: 
0668
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
ECI: 
Yes
Manuscript Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
Manuscript Status: 
Published