Trends in Primary Prevention with Statin

<h2 id="background">Background</h2><ul><li>Statins lower cholesterol and can reduce the riskforheartand circulatory disease.</li><li>American College of Cardiology and the American Heart Association (ACC/AHA) expanded statin eligibility for primary prevention on the basis of atherosclerotic cardiovascular disease (ASCVD) risk score.</li><li>Previous studies have not assessed the effect of guideline change.</li><li>Authors have hypothesized greater increases in statin use for primary prevention among adults.</li></ul><h2 id="aim">Aim</h2><p>To describe trends in statin use for primary prevention across indication categories and ASCVD risk scores.</p><h2 id="method">Methods</h2><ul><li>A repeated cross-sectional study examining statin use.</li><li>Nonpregnant adults aged &gt; 20 years with no known ASCVD and who provided fasting laboratory data from N HANES (National Health and Nutrition Examination Survey) from 1999 to 2018 were studied.</li><li>In 2013, the American College of Cardiology and the American Heart Association (ACC/AHA) expanded indications for which clinicians could prescribe statins to adults for primary prevention, including risk scores for ASCVD above a certain threshold.</li><li>Researchers studied trends in statin use between 1999 and 2018 using National Health and Nutrition Examination Survey data for 21,961 adults older than 20 years who did not have ASCVD.&nbsp;</li><li>They analyzed data from before and after implementation of the 2013 guidelines.</li></ul><h2 id="findings">Findings</h2><ul><li>Statin usage increased since 1999 but peaked at 35% in 2013 despite the expanded ACC/AHA guidelines.&nbsp;</li><li>No changes in usage were observed for the proportion ofadults who were newly eligibleforstatins.</li><li>Statin use among patients with diabetes increased by 31.1 percentage points between 1999 and 2014 butthen remained stagnant from 2014 to 2018 (Figure 1).</li><li>Statin use among those with ASCVD risk of more than 20% increased by 23.1 percentage points between 1999 and 2013 but did not increase between 2013 and 2018 (Figure 2).</li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/primary-preventions.png" width="876" height="500"></p><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/ascvd-riskscore.png" width="876" height="500"></p><h2 id="practice">In Practice</h2><ul><li>Study suggests that novel efforts, informed by implementation science and targeting patients with the greatest risk, are urgently needed.</li><li>Tools embedded in the electronic health record to calculate ASCVD risk are one possibility that might help raise awareness that the patient is eligible for a statin.</li></ul>

Cardiology Update   Issue 1   Jan 2024   Final

<ul><li><a href="#background">Background</a></li><li><a href="#aim">Aim</a></li><li><a href="#method">Methods</a></li><li><a href="#findings">Findings</a></li><li><a href="#practice">In Practice</a></li></ul>

Trends in Primary Prevention with Statin

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