Related Experiment Video
Updated: Nov 22, 2025
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Statin Use in Older Adults with Stable Atherosclerotic Cardiovascular Disease
Gabriela Spencer-Bonilla1, Sukyung Chung2,3, Ashish Sarraju4
1Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
Insights
Despite increasing use, guideline-recommended statins for atherosclerotic cardiovascular disease (ASCVD) remain underprescribed in adults over 75. Disparities in statin prescription were observed among women and those with specific comorbidities.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Older adults (over 75) account for two-thirds of atherosclerotic cardiovascular disease (ASCVD) deaths.
- Current guidelines recommend statin therapy for older adults with ASCVD.
Purpose of the Study:
- To examine trends in statin prescribing patterns.
- To identify predictors of statin prescription in older adults with ASCVD.
Main Methods:
- Retrospective longitudinal study using electronic health record (EHR) data from 2007 to 2018.
- Included 24,651 adults over 75 with ASCVD.
- Multivariable regression models analyzed statin prescription predictors.
Main Results:
- Moderate/high intensity statin prescriptions increased but remained underused, with only 45% receiving them in 2018.
- Women, patients with heart failure or dementia, and underweight patients were less likely to receive statins.
- Identified significant predictors of statin underprescription.
Conclusions:
- Guideline-recommended statins are underused in older adults with ASCVD, despite increasing rates.
- Significant disparities in statin use exist, particularly for women and those with comorbidities.
- Further research is needed to understand and address the reasons for statin underuse.
Background/Objectives:
Older adults (>75 years of age) represent two-thirds of atherosclerotic cardiovascular disease (ASCVD) deaths. The 2013 and 2018 American multi-society cholesterol guidelines recommend using at least moderate intensity statins for older adults with ASCVD. We examined annual trends and statin prescribing patterns in a multiethnic population of older adults with ASCVD.
Design:
Retrospective longitudinal study using electronic health record (EHR) data from 2007 to 2018.
Setting:
A large multi-specialty health system in Northern California.
Participants:
A total of 24,651 adults older than 75 years with ASCVD.
Measurements:
Statin prescriptions for older adults with known ASCVD were trended over time. Multivariable regression models were used to identify predictors of statin prescription (logistic) after controlling for relevant demographic and clinical factors.
Results:
The study cohort included 24,651 patients older than 75 years; 48% were women. Although prescriptions for moderate/high intensity statins increased over time for adults over 75, fewer than half of the patients (45%) received moderate/high intensity statins in 2018. Women (odds ratio (OR) = 0.77; 95% confidence interval (CI) = 0.74, 0.80), patients who had heart failure (OR = 0.69; 95% CI = 0.65, 0.74), those with dementia (OR = 0.88; 95% CI = 0.82, 0.95) and patients who were underweight (OR = 0.64; 95% CI = 0.57, 0.73) were less likely to receive moderate/high intensity statins.
Conclusions:
Despite increasing prescription rates between 2007 and 2018, guideline-recommended statins remained underused in older adults with ASCVD, with more pronounced disparities among women and those with certain comorbidities. Future studies are warranted to examine reasons for statin underuse in older adults with ASCVD.
Related Concept Videos
01:26Atherosclerosis III: Management
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
01:23Atherosclerosis IV: Nursing Management
01:26Angina IV: Management
01:27Coronary Artery Disease V: Interprofessional Care