Statin use in the US for secondary prevention of cardiovascular disease remains suboptimal
The Journal of the American Board of Family Medicine, 2019•Am Board Family Med
Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of
mortality in the United States. The purpose of this study is to examine the rates of statin use
for secondary prevention of ASCVD events in the United States over the last decade and
determine whether disparities in the treatment of ASCVD still persist among women and
racial/ethnic minorities. Methods: We conducted a trend analysis using data from 2008
through 2016 to describe age-adjusted trends in the use of statins for secondary prevention …
mortality in the United States. The purpose of this study is to examine the rates of statin use
for secondary prevention of ASCVD events in the United States over the last decade and
determine whether disparities in the treatment of ASCVD still persist among women and
racial/ethnic minorities. Methods: We conducted a trend analysis using data from 2008
through 2016 to describe age-adjusted trends in the use of statins for secondary prevention …
Background
Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study is to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities.
Methods
We conducted a trend analysis using data from 2008 through 2016 to describe age-adjusted trends in the use of statins for secondary prevention using the Medical Expenditure Panel Survey. We also conducted a multivariable logistic regression analysis to determine whether sociodemographic characteristics are associated with statin use during the 3 years that followed the publication of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline (2014 through 2016).
Results
The prevalence of statin use among those with a history of ASCVD remained unchanged from 2008 through 2016. In 2014 to 2016, more than 40% of those aged 40 years and older with a history of ASCVD did not use statins, corresponding to approximately 9.5 million Americans. Increasing age and having been diagnosed with high cholesterol (odds ratio [OR], 6.22; P < .001) were associated with higher odds of statin use while being female (OR, 0.65; P < .001) or Hispanic (OR, 0.69; P = .011) were associated with lower odds of statin use.
Conclusions
Our study found there was no increase in the national rates of statin use following the ACC/AHA 2013 secondary prevention guideline and the availability of generic statins. Significant gender and ethnic disparities in ASCVD treatment remained in the United States.
Am Board Family Med