Abstract
Objectives Healthy user bias arises when users of preventive medications such as lipid-lowering drugs (LLDs), hormone replacement therapy and antihypertensive (AH) medications are healthier than nonusers due to factors other than medication effects, making the medications appear more beneficial in observational studies of effectiveness and safety. The purpose of the study is to examine factors contributing to healthy user effect in patients taking AHs or LLDs. Methods Among patients with hypertension or hyperlipidaemia in a population-based sample from the National Health and Nutrition Examination Survey (1999-2010), we assessed the association between socioeconomic and lifestyle factors and the use of AHs/LLDs by logistic regression with adjustment for demographics and comorbidities in a cross-sectional study. Results When 9715 AH/LLD users were compared with 3725 non-users, AH/LLD users were more likely to be: highly educated (OR 1.2, 95% CI 1.2 to 1.3), nonimpoverished (OR 1.3, 95% CI 1.2 to 1.4), current nonsmokers (OR 1.2, 95% CI 1.1 to 1.4), physically active (OR 1.1, 95% CI 1.0 to 1.2) and consume more calcium (OR 1.1, 95% CI 1.0 to 1.3) but less likely to have normal body mass index (OR 0.6, 95% CI 0.6 to 0.7) or to meet dietary sodium recommendations (OR 0.8, 95% CI 0.7 to 0.9). Conclusions We identified several salutary lifestyle factors associated with AH/LLD use in a representative US population. Healthy user effect may be partly explained by better socioeconomic profiles and lifestyles in AH/LLD users compared with non-users.
| Original language | English |
|---|---|
| Article number | e000417 |
| Journal | Open Heart |
| Volume | 4 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Mar 2017 |
| Externally published | Yes |
Cite this
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Potential contribution of lifestyle and socioeconomic factors to healthy user bias in antihypertensives and lipidlowering drugs. / Kinjo, Mitsuyo; Lai, Edward Chia Cheng; Korhonen, Maarit; McGill, Rita L.; Setoguchi, Soko.
In: Open Heart, Vol. 4, No. 1, e000417, 01.03.2017.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Potential contribution of lifestyle and socioeconomic factors to healthy user bias in antihypertensives and lipidlowering drugs
AU - Kinjo, Mitsuyo
AU - Lai, Edward Chia Cheng
AU - Korhonen, Maarit
AU - McGill, Rita L.
AU - Setoguchi, Soko
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objectives Healthy user bias arises when users of preventive medications such as lipid-lowering drugs (LLDs), hormone replacement therapy and antihypertensive (AH) medications are healthier than nonusers due to factors other than medication effects, making the medications appear more beneficial in observational studies of effectiveness and safety. The purpose of the study is to examine factors contributing to healthy user effect in patients taking AHs or LLDs. Methods Among patients with hypertension or hyperlipidaemia in a population-based sample from the National Health and Nutrition Examination Survey (1999-2010), we assessed the association between socioeconomic and lifestyle factors and the use of AHs/LLDs by logistic regression with adjustment for demographics and comorbidities in a cross-sectional study. Results When 9715 AH/LLD users were compared with 3725 non-users, AH/LLD users were more likely to be: highly educated (OR 1.2, 95% CI 1.2 to 1.3), nonimpoverished (OR 1.3, 95% CI 1.2 to 1.4), current nonsmokers (OR 1.2, 95% CI 1.1 to 1.4), physically active (OR 1.1, 95% CI 1.0 to 1.2) and consume more calcium (OR 1.1, 95% CI 1.0 to 1.3) but less likely to have normal body mass index (OR 0.6, 95% CI 0.6 to 0.7) or to meet dietary sodium recommendations (OR 0.8, 95% CI 0.7 to 0.9). Conclusions We identified several salutary lifestyle factors associated with AH/LLD use in a representative US population. Healthy user effect may be partly explained by better socioeconomic profiles and lifestyles in AH/LLD users compared with non-users.
AB - Objectives Healthy user bias arises when users of preventive medications such as lipid-lowering drugs (LLDs), hormone replacement therapy and antihypertensive (AH) medications are healthier than nonusers due to factors other than medication effects, making the medications appear more beneficial in observational studies of effectiveness and safety. The purpose of the study is to examine factors contributing to healthy user effect in patients taking AHs or LLDs. Methods Among patients with hypertension or hyperlipidaemia in a population-based sample from the National Health and Nutrition Examination Survey (1999-2010), we assessed the association between socioeconomic and lifestyle factors and the use of AHs/LLDs by logistic regression with adjustment for demographics and comorbidities in a cross-sectional study. Results When 9715 AH/LLD users were compared with 3725 non-users, AH/LLD users were more likely to be: highly educated (OR 1.2, 95% CI 1.2 to 1.3), nonimpoverished (OR 1.3, 95% CI 1.2 to 1.4), current nonsmokers (OR 1.2, 95% CI 1.1 to 1.4), physically active (OR 1.1, 95% CI 1.0 to 1.2) and consume more calcium (OR 1.1, 95% CI 1.0 to 1.3) but less likely to have normal body mass index (OR 0.6, 95% CI 0.6 to 0.7) or to meet dietary sodium recommendations (OR 0.8, 95% CI 0.7 to 0.9). Conclusions We identified several salutary lifestyle factors associated with AH/LLD use in a representative US population. Healthy user effect may be partly explained by better socioeconomic profiles and lifestyles in AH/LLD users compared with non-users.
UR - http://www.scopus.com/inward/record.url?scp=85015211735&partnerID=8YFLogxK
U2 - 10.1136/openhrt-2016-000417
DO - 10.1136/openhrt-2016-000417
M3 - Article
VL - 4
JO - Open Heart
JF - Open Heart
SN - 2053-3624
IS - 1
M1 - e000417
ER -