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Recommended and observed statin use among U.S. adults - National Health and Nutrition Examination Survey, 2011-2018

Angela M Thompson-Paul1, Cathleen Gillespie2, Hilary K Wall2

  • 1U.S. Public Health Service, Rockville, MD, USA; Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

Journal of Clinical Lipidology
|March 6, 2023
PubMed

Insights

The 2018 Cholesterol Guideline recommended fewer adults for statin therapy than the 2013 guideline, yet statin use remained suboptimal. Improved patient-clinician discussions are needed to boost treatment rates.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Clinical Guidelines

Background:

  • The American College of Cardiology/American Heart Association (ACC/AHA) published blood cholesterol guidelines in 2013 and a multi-society guideline in 2018.
  • These guidelines provide recommendations for the management of blood cholesterol and cardiovascular disease risk.

Purpose of the Study:

  • To compare population-level estimates of statin recommendations and usage between the 2013 and 2018 cholesterol guidelines.
  • To identify differences in guideline application across various demographic and patient management groups.

Main Methods:

  • Analysis of National Health and Nutrition Examination Survey data (2011-2018) from 8,642 non-pregnant adults.
  • Comparison of statin recommendation prevalence and use based on criteria from the 2013 and 2018 Cholesterol Guidelines.

Main Results:

  • The 2018 Cholesterol Guideline recommended statins for an estimated 46.1 million adults, compared to 77.8 million under the 2013 guideline.
  • Statin use among those recommended for treatment was similar under both guidelines (approximately 47%).
  • Significant differences in recommendations and use were observed across demographic and patient management subgroups.

Conclusions:

  • The 2018 Cholesterol Guideline algorithm resulted in a lower prevalence of statin recommendations but included more individuals for consideration via risk assessment and discussion.
  • Statin utilization remained suboptimal (<50%) for individuals recommended for treatment under both guidelines.
  • Enhancing patient-clinician risk discussions and shared decision-making is crucial for improving statin treatment rates.
Abstract

Keywords:
Cardiovascular diseaseCholesterol managementNHANESStatin

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