Potential contribution of lifestyle and socioeconomic factors to healthy user bias in antihypertensives and lipidlowering drugs

Mitsuyo Kinjo, Edward Chia Cheng Lai, Maarit Korhonen, Rita L. McGill, Soko Setoguchi

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

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 languageEnglish
Article numbere000417
JournalOpen Heart
Volume4
Issue number1
DOIs
Publication statusPublished - 1 Mar 2017
Externally publishedYes

Cite this

Kinjo, Mitsuyo ; Lai, Edward Chia Cheng ; Korhonen, Maarit ; McGill, Rita L. ; Setoguchi, Soko. / Potential contribution of lifestyle and socioeconomic factors to healthy user bias in antihypertensives and lipidlowering drugs. In: Open Heart. 2017 ; Vol. 4, No. 1.
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title = "Potential contribution of lifestyle and socioeconomic factors to healthy user bias in antihypertensives and lipidlowering drugs",
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.",
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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 journalArticleResearchpeer-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.

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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

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