Discussion
we found a higher overall CHd mortality and utilization of
statins in stockholm than in sicily. If we accept CHd mortality
as a marker for CHd risk level, the results are compatible with
a hypothesis that high cardiovascular risk in general leads to a
great need for risk-lowering actions, e.g. prescription of lipid-
lowering drugs.
the mortality declined in both regions between 2001 and 2010
and the gap between the two areas decreased over time. during
the same period, statin utilization increased in both areas, with
a steeper increase in sicily.
the relation between coronary risk and statin utilization may
be considered from two angles: as an effect of statins on
cardiovascular risk, or as changes in statin utilization following
changes in risk levels. If we find a large increase in statins over
time in an area with a rapid reduction in coronary disease,
this may support the concept of statins as an important factor
behind reduction in coronary disease. If the reverse is found,
a larger increase in statin utilization in an area with slower
reduction in coronary disease, we should consider other factors