INS and chronic obstructive pulmonary disease: On the other hand, clinical factors significantly associated with higher suboptimal adherence or non-persistence were: age > 75 years; female; comorbidities of renal disease, liver disease, depression, chronic obstructive pulmonary disease, or dementia; history in the one year prior to the ASCVD hospitalization of using insulin, digitalis, oral antidiabetic agents, angiotensin-converting enzyme inhibitors (ACEIs), or diuretics (all p values < 0.01, expect for female p value < 0.05).