145Educational inequalities in primary prevention statin use in UK Biobank

Abstract Background Socioeconomic inequalities in cardiovascular disease are well documented, but the association of socioeconomic position with treatment for cardiovascular disease prevention is unclear. Methods Using data from a large prospective cohort study, UK Biobank, we calculated QRISK3 cardiovascular risk scores for 472 097 eligible participants with complete data on self-reported educational attainment and statin use (55% female; mean age, 56). We used logistic regression to explore the association between i) QRISK3 score and ii) educational attainment on self-report statin use. We then stratified the association between QRISK3 score, and statin use by educational attainment to test for interactions. Results For an equivalent QRISK3 score, more educated individuals were more likely to report taking statins. In women with 7 years of schooling, a one unit increase in QRISK3 score was associated with a 7% higher odds of statin use (odds ratio (OR) 1.07, 95% CI 1.07, 1.07). In women with 20 years of schooling, a one unit increase in QRISK3 score was associated with an 14% higher odds of statin use (OR 1.14, 95% CI 1.14, 1.15). Comparable ORs in men were 1.04 (95% CI 1.04, 1.05) for 7 years of schooling and 1.08 (95% CI 1.08, 1.08) for 20 years of schooling. Conclusions Individuals with less education are less likely to access statins conditional on cardiovascular risk factors. Key messages Inequalities in access to cardiovascular preventive medication are likely contributing to cardiovascular inequalities.