The Article in Brief
Cardiovascular Risk and Statin Use in the United States: A Cross-Sectional Analysis
Michael E. Johansen , and colleagues
Background New guidelines from the American College of Cardiology and American Heart Association substantially broaden the number of individuals for whom statin medications are recommended, primarily by expanding the eligible population to lower levels of cardiovascular risk. This study examines the relationships between statin use and cardiovascular risk, diagnosis of hyperlipidemia (high cholesterol and triglyceride levels), and other risk factors.
What This Study Found Many people at high risk for cardiovascular disease, including those with coronary artery disease, diabetes or both, are not receiving statins. An estimated nine million people over 40 years of age with diabetes and 5.6 million people with coronary artery disease--populations that have clearly been shown to benefit from the drugs--are not on statins. Those with high cholesterol but without diabetes or heart disease are more likely to be on statins than those without high cholesterol but who have diabetes or heart disease. Given that individuals with heart disease or diabetes are at considerably higher cardiovascular risk, this pattern strongly supports the notion that statin use is being driven by high cholesterol instead of by overall cardiovascular risk.
Implications
- Recently released ACC-AHA guidelines offer an opportunity to reframe statins as medications that reduce cardiovascular risk rather than as medications that lower cholesterol.