Statins, a class of cholesterol-lowering medications that inhibit 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase, are commonly administered to treat atherosclerotic cardiovascular disease. Statin use may expand considerably given its potential for treating an array of cholesterol-independent diseases. However, the lack of conclusive evidence supporting these emerging therapeutic uses of statins brings to the fore a number of unanswered questions including uncertainties regarding patient-to-patient variability in response to statins, the most appropriate statin to be used for the desired effect, and the efficacy of statins in treating cholesterol-independent diseases. In this review, the adverse effects, costs, and drug–drug and drug–food interactions associated with statin use are presented. Furthermore, we discuss the pleiotropic effects associated with statins with regard to the onset and progression of autoimmune and inflammatory diseases, cancer, neurodegenerative disorders, strokes, bacterial infections, and human immunodeficiency virus. Understanding these issues will improve the prognosis of patients who are administered statins and potentially expand our ability to treat a wide variety of diseases.

BackgroundCardiovascular disease (CVD) is the leading cause of deaths worldwide. In the majority of patients, CVD is specifically attributed to the development of atherosclerosis primarily caused by elevated plasma cholesterol levels. Statins, HMG‐CoA reductase inhibitors, are the preferential treatment for hypercholesterolemia‐induced cardiovascular‐associated diseases. When taken as prescribed, statins are highly effective in lowering high cholesterol levels, thereby reducing the eventuality of heart attack and stroke significantly. However, despite the demonstrable efficacy and safety that surrounds statin use, the adherence rates of statin therapy are markedly low. There are a myriad of contributing potential factors. Non‐adherence affects us all and is a cyclic process associated with increased disease burden. This leads to augmented use of healthcare services, which turn into significant healthcare costs that are passed onto the patient. This further potentiates poor medication adherence.AimThe purpose of this study was to evaluate the relationships between certain factors (i.e. sociodemographic, medication beliefs, self‐efficacy, health status, etc.) and adherence to prescribed statin therapy assessed using a composite questionnaire.MethodsAdult patients ≥18 (n = 74) of providers at the University of Kentucky Internal Medicine Group clinic who presented to the waiting room for appointments and were current or previous statin users completed the 21‐question survey during their clinic visit. Respondents' self‐reported survey data was subsequently linked to corresponding electronic health registry (EHR) data.The survey consisted of previously validated questionnaires to evaluate which variable(s) and/or mediator(s) were the most significant contributor to medication non‐adherence. Forward stepwise multiple regressions were performed in which a dependent variable was regressed on to a set of potential explanatory variables in a stepwise fashion.ResultsA total of 74 adults completed the paper surveys. Adherence and medication‐taking behavior were measured using an adapted Medication Adherence Rating Scale (MARS) questionnaire. When adherence was used as a result variable, a significant correlation between the MARS rating and domains of patient attitudes & beliefs including Efficacy Beliefs, Medication Worries, and Personal Locus of Control were observed. Adherence was also significantly correlated to employment status, annual income and provider accessibility. Surprisingly, statin‐type shared no significant relationship with any of the variables/domains evaluated.ConclusionsNon‐adherence to statin therapy may arise from several factors that occur in a concerted or mutually exclusive manner. Contributing factors include efficacy beliefs, medication worries, and sociodemographic barriers. Further elucidating the extent to which these factors contribute to non‐adherence in the general population will aid in the development of effective interventions to be used for improving patient adherence to medications like statins.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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