| Summary: | <strong>Background:</strong> Suboptimal use of cardiovascular prevention medications has been reported. We report recent trends in secondary cardiovascular disease (CVD) prevention drug use in Europe. <strong>Design:</strong> Study of Health and Retirement in Europe (SHARE), a large longitudinal 2004-2013 cohort study in middle-aged and elderly Europeans. <strong>Methods:</strong> Cross-sectional and panel logistic regression models were used to study trends in cholesterol- and blood pressure (BP)-lowering drug use and effects of individual characteristics among participants with CVD in SHARE. <strong>Results:</strong> 21,371 SHARE participants reported cardiovascular disease and, at initial report, 40% and 60% of them used cholesterol- or BP-lowering drugs, respectively. Increasing cross-sectional time trends were observed for both medication classes (odds ratios [OR] of use in 2013 vs 2004, 1.6 [95%CI 1.4-1.7] and 1.5 [1.4-1.6], respectively). However, among individuals with multiple observations, the use of both classes declined over time (2013 vs 2004 OR 0.63 [0.51-0.77] and 0.68 [0.55-0.84]; both trend p<0.001), and with increasing duration since last cardiovascular event (OR 0.74 [0.60-0.91], trend p=0.01 and OR 0.82 [0.66-1.03], trend p=0.06, respectively for durations of 9 years or more versus less than one year). Among people with CVD, those obese, retired or with hypercholesterolemia, hypertension, worse self-perceived health, and, in the case of lipid-lowering medication, with diabetes, were more likely to use these medications. <strong>Conclusions:</strong> Despite moderately increasing cross-sectional time trends, the use of secondary CVD prevention drugs remains low in Europe with substantial discontinuation over time and with increasing duration from an acute cardiovascular event.
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