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Published on: November 10, 2017

Racial differences in reaching target low-density lipoprotein goal among individuals treated with prescription statin

Marianne Ulcickas Yood1, Bruce D McCarthy, Judy Kempf

  • 1EpiSource, Hamden, CT, USA. muyood@muyood.com

American Heart Journal
|September 26, 2006
PubMed

Insights

African Americans are less likely to reach their low-density lipoprotein (LDL) goal when treated with statins compared to whites. This disparity persists even after accounting for adherence and other factors, suggesting potential differences in treatment needs.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Health Disparities

Background:

  • African Americans generally have poorer hyperlipidemia control than white individuals.
  • Previous research has not examined racial differences in achieving low-density lipoprotein (LDL) goals among treated patients.

Purpose of the Study:

  • To investigate the effect of race on achieving target LDL goals in patients initiating statin therapy.
  • To compare LDL goal attainment between African American and white patients receiving statins.

Main Methods:

  • Retrospective analysis of computerized data from a Midwestern health system.
  • Inclusion of adult African American and white patients who filled their first statin prescription between January 1, 1997, and June 30, 2001.
  • Follow-up of LDL cholesterol levels for one year post-index prescription.

Main Results:

  • A total of 16,052 new statin users were identified, with 32.5% being African American.
  • African Americans had higher mean baseline LDL levels (170.2 mg/dL) than whites (161.8 mg/dL).
  • Whites demonstrated higher adherence to statin therapy (48.6% vs. 31.2%) and were more likely to reach their LDL goal (71.1% vs. 49.5%).
  • Even after adjusting for adherence, income, and other factors, African Americans were significantly less likely to achieve LDL goal (HR 0.60, 95% CI 0.57-0.63).

Conclusions:

  • African American patients initiating statin therapy are less likely to achieve their LDL goal compared to white patients.
  • This racial disparity in LDL goal attainment is not fully explained by differences in statin adherence or other measured covariates.
  • Findings suggest that African Americans may require tailored or alternative pharmacologic management strategies for hyperlipidemia.
Abstract

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