Association between statin use and progression of arterial stiffness among adults with high atherosclerotic risk

Importance

Limited studies have investigated the association between statin use and progression of arterial stiffness, a key player in the pathophysiology of cardiovascular disease.

Objective

To examine the association between statin use and progression of arterial stiffness in Chinese adults with high atherosclerotic risk measured by brachial-ankle pulse wave velocity (baPWV).

Design, Setting, and Participants

This retrospective cohort study enrolled 5105 adults with high atherosclerotic risk from the Kailuan General Hospital from 2010 to 2020. Data were analyzed from February 2021 to April 2022.

Exposures

Statin use information was retrieved from electronic medical records from 2010 to 2020, and statin users were those who have been prescribed any statin medications at least 6 months before baPWV measurements. Statin users were 1:1 matched with non–statin users by propensity score method.

Main Outcomes and Measures

Progression of baPWV was assessed using the absolute difference between baseline and follow-up baPWV, divided by the follow-up time in years. Multivariable linear regression models were used to estimate the association between statin use and arterial stiffness.

Results

Among 5105 adults with assessment of baPWV (mean [SD] age: 60.8 [9.7] years; 3842 [75.3%] men and 1263 [24.7%] women), 1310 statin users were matched with 1310 non–statin users (mean [SD] age, 63.2 [9.3] years). Compared with non–statin users, statin users were associated with significantly lower baPWV at baseline (difference: −33.6 cm/s; 95% CI, −62.1 to −5.1 cm/s). Among 1502 adults with repeated assessment of baPWV, 410 statin users were matched with 410 non–statin users (mean [SD] age, 62.9 [9.2] years). Compared with non–statin users, statin users had significantly slower progression of baPWV (difference, −23.3 cm/s per year; 95% CI, −40.6 to −6.0 cm/s per year) during a mean (SD) follow-up of 4.8 (2.7) years. A significantly slower progression of baPWV was observed in continuous statin users (difference, −24.2 cm/s per year; 95% CI, −42.2 to −6.3 cm/s per year) and high adherent users (difference, −39.7 cm/s per year; 95% CI, −66.9 to −12.4 cm/s per year), but not in discontinued users (difference, −17.3 cm/s per year; 95% CI, −52.4 to 17.8 cm/s per year) and low adherent users (difference, −17.9 cm/s per year; 95% CI, −36.5 to 0.7 cm/s per year), compared with non–statin users.

Conclusions and Relevance

In this cohort study, statin use was associated with slower progression of arterial stiffness in Chinese adults with high atherosclerotic risk.