Original ArticleHypothyroidism as a risk factor for statin intolerance
Section snippets
Methods
Data from the electronic medical record database of the Intermountain Healthcare system (Murray, UT) were studied to address 4 objectives in a general health care population: (1) to determine the prevalence of hypothyroidism in patients with documented intolerance to at least 1 statin; (2) to provide sex-specific analysis of the relationship between statin intolerance and hypothyroidism; (3) to evaluate the development of hypothyroidism in persons with and without statin intolerance; and (4) to
Results
Demographics are presented in Table 1. A study population of n = 10,789 subjects was identified with 47.9% males and 52.1% females. The mean age of all subjects was 67.2 ± 11.4 years. Males were older than females (P < .0001). Overall, 2686 subjects had statin intolerance matched 3:1 to 8103 controls with no history of statin intolerance. Persons with statin intolerance were more likely to have hypertension (P < .0001), diabetes (P < .0001), coronary artery disease (P = .0001), a history of
Summary of study findings
In the present study, we demonstrate that people who have an established diagnosis of hypothyroidism are more likely to have statin intolerance, and females more than males. We also show that those who have statin intolerance without a history of hypothyroidism are more likely to subsequently develop hypothyroidism. Additionally, statin intolerance and hypothyroidism appear to be independent and additive negative predictors of the likelihood that a person will be on a statin at follow-up. We
Conclusions
In conclusion, in a large health care system's database, we found hypothyroidism to be more prevalent in those with statin intolerance, both in males and, especially, in females. People with hypothyroidism are less likely to have a prescription for a statin at follow-up than those without hypothyroidism. Recognizing this interaction may lead to improved, more personalized care in these patients.
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2016, Value in HealthCitation Excerpt :The study, however, focused only on statin discontinuation and analyzed only the first-reported statin-related event. Similarly, Robison et al. [34] used the Intermountain Healthcare EMR database to identify patients with a documented history of SI with and without hypothyroidism. The algorithm, however, was not validated and had numerous other limitations: patients were not required to have a minimum duration of statin therapy; there was no requirement to attempt therapy with more than one statin; the analysis was conducted in a predominantly white population; and the study did not collect information on the specific statins taken by patients or on statin dosage.
Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update (2016)
2016, Canadian Journal of CardiologyCitation Excerpt :However, underlying hypothyroidism is recognized as a potential contributing factor to statin intolerance, particularly muscle effects.299,300 A recent analysis of the Intermountain Healthcare electronic medical claims database compared statin users with and without statin intolerance.301 The OR for hypothyroidism in those with vs without statin intolerance was 1.49 (P < 0.0001), with women being particularly susceptible.
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Financial Disclosures: None.
Conflicts of Interests: None.