Long-term statin use and psychological well-being

Abstract

Objectives: We sought to study the effect of long-term statin use on psychometric measures in an adult population with underlying coronary artery disease (CAD).

Background: Previous studies have suggested associations between cholesterol lowering and psychological well-being.

Methods: Study subjects were recruited from an outpatient cardiology clinic. Psychological well-being was assessed at baseline and annually during follow-up. The exposure of interest was long-term statin use and the outcomes of interest were depression, anxiety, and hostility. We estimated the odds ratios (ORs) and 95% confidence intervals (CI) that represented the strength of association between statin use (vs. no use of any cholesterol-lowering drug) and the risk of having abnormal depression, anxiety, and hostility scores.

Results: Study subjects had an average follow-up of four years and maximum of seven years. Comparing the 140 patients who had continuous use of statins with the 231 patients who did not use any cholesterol-lowering drugs, statin use was associated with lower risk of abnormal depression scores (OR 0.63, 95% CI 0.43 to 0.93), anxiety (OR 0.69, 95% CI 0.47 to 0.99), and hostility (OR 0.77, 95% CI 0.58 to 0.93) after adjustment for the propensity for statin use and potential confounders. The beneficial psychological effects of the statins appeared to be independent of the drugs' cholesterol-lowering effects.

Conclusions: Long-term use of statins among patients with CAD appeared to be associated with reduced risk of anxiety, depression, and hostility.

Figure 1

Association between change in Kellner Symptom Questionnaire score and consecutive years of statin use or no use of cholesterol-lowering drugs.

Figure 2

Odds ratios of abnormal psychometric scores and length of consecutive statin usage. *The generalized estimating equations longitudinal multivariate model with adjustment for propensity, as well as age (age minus mean age); length of follow-up; gender; education (below vs. above college education); blood glucose level; systolic and diastolic blood pressure; total cholesterol; high density lipoprotein level; heart rate; current smoking; regular exercise; alcohol use; past major life events; anticipated major future life events; use of antidepressants and anti-anxiety drugs at time of enrollment; statin use prior to study entry; use of beta blockers or calcium channel blockers at enrollment and during follow-up; history of catheterization, myocardial infarction, hypertension, and diabetes; incidence of myocardial infarction, stroke, catheterization, and revascularization.