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Background: Study of medication adherence patterns can help identify patients who would benefit from effective interventions to improve adherence.Objectives: To identify and compare groups of statin users based on their adherence patterns before and during the COVID-19 pandemic, to characterize the profile of users in each group, and to analyze predictors of distinct adherence patterns.Methods: Participants of the CARhES (CArdiovascular Risk factors for HEalth Services research) cohort, comprising individuals aged >16 years, residing in Aragón (Spain), with hypertension, diabetes mellitus and/or dyslipidemia, took part in this observational longitudinal study. Individuals who began statin therapy during January–June 2019 were selected and followed up until June 2021. Those with a cardiovascular event before or during follow-up were excluded. Data were obtained from healthcare system data sources. Statin treatment adherence during the implementation phase was estimated bimonthly using the Continuous Medication Availability (CMA9) function in the AdhereR package. Group-based trajectory models were developed to group statin users according to their adherence pattern during July 2019–June 2021. Group characteristics were compared and predictors of each adherence pattern were analyzed using multinomial logistic regression.Results: Of 15,332 new statin users, 30.8% had a mean CMA9 ≥80% for the entire study period. Four distinct adherence patterns were identified: high adherence (37.2% of the study population); poor adherence (35.6%); occasional use (14.9%); and gradual decline (12.3%). The latter two groups included users who showed a change in adherence (increase or decrease) during the pandemic emergence. Users with suboptimal adherence were likely to be younger, not pensioners, not institutionalized, with low morbidity burden and a low number of comorbidities. Female sex and switching between statins of different intensity increased the likelihood of belonging to the occasional use group, in which improved adherence coincided with the pandemic.Conclusion: We identified four distinct adherence patterns in a population of new statin users; two of them modified their adherence during the pandemic. Characterization of these groups could enable more effective distribution of resources in future similar crisis and the routine implementation of patient-centered interventions to improve medication adherence.

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Objective: the aim of this analysis was to measure the association between daily sitting time and prevalent metabolic syndrome, independently of the physical activity performed. Subjects and methods: the Aragon Workers' Health Study cohort consists of 5 865 participants from which a sample of 1 415 male participants (40-55 years old) with completed data at baseline was selected. Sitting time and physical activity were assessed by validated questionnaires, and the socio-demographic, clinical and biochemical covariates needed to diagnose metabolic syndrome were collected as part of the study protocols. Metabolic syndrome was defined according to the modified National Cholesterol Education Program - Adult Treatment Panel III. Multiple linear and logistic regression models were carried out to quantify this association using sitting time categorized into tertiles. Results: mean sitting time was 5.78 ± 1.72 h/day, and the prevalence of metabolic syndrome was 19.2%. Comparing participants in the highest (> 6.57 h/day) versus lowest (1.85-4.57 h/day) tertile of sitting time, a positive association was observed for metabolic syndrome (OR 1.77, 95%CI: 1.25-2.49) and triglyceride (OR 1.70, 95%CI: 1.30-2.24), HDL-cholesterol (OR 1.65, 95%CI: 1.06-2.58), waist circumference (OR 1.57, 95%CI: 1.17-2.11) and fasting blood glucose (OR 1.35, 95%CI: 1.03-1.77) criteria, adjusting the level of physical activity. Conclusions: higher sitting time is associated with an increased prevalence of metabolic syndrome independently of physical activity performed. These results could be useful to carry out effective strategies for cardiovascular health promotion especially in workplaces. Objetivo: el objetivo del presente análisis fue medir la asociación entre el tiempo sentado y la prevalencia de síndrome metabólico, de forma independiente a la actividad física realizada. Sujetos y métodos: la cohorte del Aragon Workers' Health Study está formada por 5.865 participantes de los cuales se seleccionó una muestra de 1.415 voluntarios varones (40-55 años) con datos completos al inicio del estudio. El tiempo sentado y la actividad física se valoraron mediante cuestionarios validados, y las variables sociodemográficas, clínicas y bioquímicas necesarias para el diagnóstico del síndrome metabólico fueron recogidas como parte de los protocolos del estudio. Para la definición de síndrome metabólico se siguieron los criterios del Programa Nacional de Educación del Colesterol en el marco del III Panel de Tratamiento de Adultos (NCEPATP III). Se llevaron a cabo modelos de regresión lineal y logística para cuantificar esta asociación usando el tiempo sentado categorizado en tertiles. Resultados: la media de tiempo sentado fue de 5,78 ± 1,72 h/día, y la prevalencia de síndrome metabólico del 19,2%. Comparando los participantes en el tertil superior de tiempo sentado frente a los del tertil inferior observamos una asociación positiva para síndrome metabólico (OR 1,77, 95%CI: 1,25-2,49) y los criterios de triglicéridos (OR 1,70, 95%CI: 1,30-2,24), HDL-colesterol (OR 1,65, 95%CI: 1,06-2,58), circunferencia de cintura (OR 1,57, 95%CI: 1,17-2,11) y glucosa en ayunas (OR 1,35, 95%CI: 1,03-1,77), ajustando por el nivel de actividad física. Conclusiones: un mayor tiempo sentado se asocia con un aumento de la prevalencia de síndrome metabólico independientemente de la actividad física realizada. Estos resultados podrían ser útiles para llevar a cabo estrategias efectivas de promoción de la salud cardiovascular, especialmente en los lugares de trabajo.

Objective: the aim of this analysis was to measure the association between daily sitting time and prevalent me-tabolic syndrome, independently of the physical activity performed. Subjects and methods: the Aragon Workers’ Health Study cohort consists of 5 865 participants from which a sample of 1 415 male participants (40-55 years old) with completed data at baseline was selected. Sitting time and physical activity were assessed by validated questionnai-res, and the socio-demographic, clinical and biochemical covariates needed to diagnose metabolic syndrome were collected as part of the study protocols. Metabolic syn-drome was defined according to the modified National Cholesterol Education Program - Adult Treatment Panel III. Multiple linear and logistic regression models were carried out to quantify this association using sitting time categorized into tertiles. Results: mean sitting time was 5.78 ± 1.72 h/day, and the prevalence of metabolic syndrome was 19.2%. Compar-ing participants in the highest (> 6.57 h/day) versus lowest (1.85-4.57 h/day) tertile of sitting time, a positive asso-ciation was observed for metabolic syndrome (OR 1.77, 95%CI: 1.25-2.49) and triglyceride (OR 1.70, 95%CI: 1.30-2.24), HDL-cholesterol (OR 1.65, 95%CI: 1.06-2.58), waist circumference (OR 1.57, 95%CI: 1.17-2.11) and fasting blood glucose (OR 1.35, 95%CI: 1.03-1.77) crite-ria, adjusting the level of physical activity Conclusions: higher sitting time is associated with an increased prevalence of metabolic syndrome independently of physical activity performed. These results could be useful to carry out effective strategies for cardiovascular health promotion especially in workplaces

Objective: the aim of this analysis was to measure the association between daily sitting time and prevalent metabolic syndrome, independently of the physical activity performed. Subjects and methods: the Aragon Workers' Health Study cohort consists of 5 865 participants from which a sample of 1 415 male participants (40-55 years old) with completed data at baseline was selected. Sitting time and physical activity were assessed by validated questionnaires, and the socio-demographic, clinical and biochemical covariates needed to diagnose metabolic syndrome were collected as part of the study protocols. Metabolic syndrome was defined according to the modified National Cholesterol Education Program - Adult Treatment Panel III. Multiple linear and logistic regression models were carried out to quantify this association using sitting time categorized into tertiles. Results: mean sitting time was 5.78 ± 1.72 h/day, and the prevalence of metabolic syndrome was 19.2%. Comparing participants in the highest (> 6.57 h/day) versus lowest (1.85-4.57 h/day) tertile of sitting time, a positive association was observed for metabolic syndrome (OR 1.77, 95%CI: 1.25-2.49) and triglyceride (OR 1.70, 95%CI: 1.30-2.24), HDL-cholesterol (OR 1.65, 95%CI: 1.06-2.58), waist circumference (OR 1.57, 95%CI: 1.17-2.11) and fasting blood glucose (OR 1.35, 95%CI: 1.03-1.77) criteria, adjusting the level of physical activity. Conclusions: higher sitting time is associated with an increased prevalence of metabolic syndrome independently of physical activity performed. These results could be useful to carry out effective strategies for cardiovascular health promotion especially in workplaces.