Prevalence and Factors Associated With Statin Use Among a Nationally Representative Sample of US Adults: National Health and Nutrition Examination Survey, 2011–2012

Abstract

Background The 2013 American College of Cardiology/American Heart Association guidelines recommend statins for adults ≤75 years who have clinical atherosclerotic cardiovascular disease (ASCVD) (IA) and for adults aged 40 – 75 with diabetes and LDL-C 70-189 mg/dl (IA). Our aim was to estimate the prevalence and likelihood of statin use among selected statin benefit groups. Methods Using data from the National Health and Nutrition Examination Survey (NHANES) 2011 – 2012, we examined 5,319 adults ≥20 years. We estimated weighted frequencies and prevalence of statin use for adults with diabetes and dyslipidemia (or LDL ≥70 mg/dl), defined as statin benefit group 1 (SBG1); and for adults with ASCVD, defined as statin benefit group 2 (SBG2). We constructed a logistic regression model to estimate the odds of statin use in SBG1. Results Overall, an estimated 38.6 million Americans are on a statin. In adjusted models, uninsured and Hispanic adults were less likely to be on a statin compared to white adults. 59.5% (95% CI: 53.0 – 66.1) of all adults in SBG1, 58.8% (95% CI: 51.5 – 66.1) of adults aged 40 – 75 in SBG1 and 63.5% (95% CI: 55.6 – 71.4) of all adults in SBG2 were on a statin. Conclusion Although the prevalence of statin use has increased over time, Hispanic ethnicity and lack of insurance remain a barrier to statin use. Black-white racial disparities were not significant. Our study provides a baseline estimate of statin use in the non-institutionalized population just prior to the introduction of the new guidelines and provides a reference for evaluating the impact of the new guidelines on statin utilization.

Statin use in Brazil: findings and implications

“…The prevalence of statin use in Brazilian primary health care in this study (9.3%) was lower than in high income countries, such as the United Kingdom (12.8% of patients) [51], and the United States (17.2% of patients) [52]; however. higher than seen in low middle income countries (4.9%), including China and Colombia [53][54][55].…”

Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study

“…Statins have become one of the most widely used drugs in the United States and some other parts of the world . According to the National Health and Nutrition Examination Survey from 2011 to 2012, an estimated 38.6 million Americans were using a statin …”

Design and rationale of the EBBINGHAUS trial: A phase 3, double‐blind, placebo‐controlled, multicenter study to assess the effect of evolocumab on cognitive function in patients with clinically evident cardiovascular disease and receiving statin background lipid‐lowering therapy—A cognitive study of patients enrolled in the FOURIER trial

“…Thus, there is an unmet need for a potent, effective nonstatin agent that will permit a significantly greater proportion of patients to achieve lower LDL‐C concentrations and further reduce cardiovascular risk . Based on current data, evolocumab may fulfill this need and provide an important addition to the treatment of hypercholesterolemia, particularly for high‐risk patients with a history of cardiovascular disease.…”

“…1 Furthermore, data continue to accrue that even among patients who achieve low low-density lipoprotein cholesterol (LDL-C) levels (ie, <70 mg/dL), cardiovascular events may be reduced even further with additional reduction in LDL-C. 1,2 Thus, there is an unmet need for a potent, effective nonstatin agent that will permit a significantly greater proportion of patients to achieve lower LDL-C concentrations and further reduce cardiovascular risk. 3,4 Based on current data, evolocumab may fulfill this need and provide an important addition to the treatment of hypercholesterolemia, particularly for high-risk patients with a history of cardiovascular disease.…”