Until last fall, the recommendations for the use of statins drugs that lower blood bad cholesterol levels (LDL) were based solely on an individual s cholesterol level. But then the American Heart Association (AHA) and the American College of Cardiology (ACC) began to recommend that physicians prescribe these drugs based on a patient s overall risk of heart attack or stroke. A new study, published in the Annals of Family Medicine, found that these newer recommendations will result in many more statin users.
Dr. Michael Edward Johnson from the Ohio State University Department of Family Medicine and colleagues from the University of Michigan, the University of Alberta, and Northwestern University, evaluated data from nearly 17,000 patients who participated in the 2010 Medical Expenditure Panel Survey. Participants were between 30 and 79 years old. The researchers defined statin users as those who reported filling at least two prescriptions for statins.
Many people who were at high risk for cardiovascular problems, such as those with coronary artery disease (CAD), diabetes or both, the report revealed, were not using statins. Indeed, only 58 percent of those with CAD and 52 percent of those with diabetes were receiving statins in that period. In both groups, however, the rate of statin use was greater when the participant had both high blood cholesterol as well as CAD or high cholesterol plus diabetes. Thus, they concluded, the under-treatment appears to be related to placing too much emphasis on hyperlipidemia and not enough on cardiovascular risk. They suggested that as many as nearly six million additional people with CAD and nine million with diabetes who were older than 40 were not regularly using statins.
ACSH medical director Dr. Gilbert Ross commented, Although statins, at least partly via their anti-inflammatory actions, have been found to benefit even people without current hyperlipidemia, these results obviously indicate that such effects are not widely considered when statins are prescribed. Now that new guidelines have been promulgated, perhaps physicians will alter their prescribing behavior and many more patients will benefit.