• Quality of Health Care
• Medication Adherence
• Drug Monitoring
• Coronary Artery Disease
• Peripheral Vascular Diseases

Statins are probably, with inhibitors of the renin–angiotensin system and beta-blockers, the most widely studied medications, with dozens of randomised clinical trials documenting their remarkable efficacy and comparatively few severe side-effects. They have also documented their unique ability to increase life expectancy both in secondary and primary prevention.

With this in mind, the findings of Thalmann et al may appear surprising.1 They have analysed medication consumption data in a large population of nearly 168 000 persons hospitalised for a cardiovascular event in Scotland from 2009 to 2017 and found that only 81% of them were treated with statins after their hospitalisation, only 40% of whom getting high-intensity statins, a proportion rising to 43% at 1 year. Patients who received statins after their hospital admissions were described as ‘initiators’, a somewhat improper term as a substantial number of them may have been on statins already before their index hospitalisation. Analysis of correlates of statin prescription showed two main prescription biases: gender, with women being 28% less likely to receive statins than men; and age, with a bimodal distribution, younger (<50 years) and older (≥70 years) patients receiving statins less frequently. In addition, patients living in the most deprived areas were treated less often (despite the fact that the cost of medications is covered by the Scottish …