Age and sex disparities in discharge statin prescribing in the stroke belt: Evidence from the reasons for geographic and racial differences in stroke study

Background--stroke is a costly and debilitating disease that disproportionately affects blacks. despite the efficacy of statins,evidence suggests racial disparities may exist in statin prescribing. methods and results--we analyzed discharge medications for participants hospitalized for an ischemic stroke during follow-up of the regards (reasons for geographic and racial differences in stroke) study. medications on admission and discharge were abstracted from medical records. among the 666 eligible incident strokes (2003-2013),analyses were restricted to 323 participants who were not statin users at the time of admission and had no history of atrial fibrillation. overall,48.7% were prescribed a statin on discharge. in the stroke belt,participants aged 65 years and older were 47% less likely to be discharged on a statin compared with those younger than 65 years (relative risk [rr],0.53; 95% ci,0.38-0.74). this association was not observed in non-stroke belt residents. outside the stroke belt,blacks were more likely than whites to be discharged on a statin (rr,1.42; 95% ci,1.04-1.94),while no black:white association was present among stroke belt residents (rr,0.93; 95% ci,0.69-1.26; p for interaction=0.228). compared with women,men in the stroke belt were 31% less likely to be discharged on a statin (rr,0.69; 95% ci,0.50-0.94) while men outside the stroke belt were more likely to be discharged on a statin (rr,1.38; 95% ci,0.99-1.92; p for interaction=0.004). conclusions--statin discharge prescribing may differ among stroke belt and non-stroke belt residents,particularly in older americans and men. © 2017 the authors and medtronic.