A major challenge in improving population outcomes for cardiovascular disease is ensuring that appropriate medical therapy is both initiated and then maintained long term after the presenting clinical event. In this issue of Heart, Dr. Grey and colleagues (see page 770) assessed continuation of statin therapy over 3 years for all patients with an acute coronary syndrome in New Zealand in 2007. Based on pharmaceutical dispensing data, they found that about 1/3 of patients were not on appropriate statin therapy over this time interval (see table 1).

In an accompanying editorial, Dr. Roth (see page 752) comments on the value of approaches that allow researchers to “link large datasets in order to yield important insights into health and healthcare” and summarizes other studies showing low levels of adherence to statin therapy. As these data emphasize, guidelines for effective therapy …