Statins Underutilized By Many Patients With Cardiovascular Risk

MedicalResearch.com Interview with
Dr. Michael Johansen, MD, MS
Department of Family Medicine
The Ohio State University
Columbus, OH 43201

MedicalResearch: What are the main findings of the study?

Dr. Johansen: We found a surprisingly low number of people with coronary artery disease and diabetes (over age 40) were not reporting statin use. Of the people with coronary artery disease only 58% reported statin use while 52% of people with diabetes reported use. In addition, a reported diagnosis of hyperlipidemia was strongly correlated with statin use. In fact, individuals with hyperlipidemia and no coronary artery disease were more apt to be on a statin than people with coronary artery disease and no hyperlipidemia. Other high-risk conditions that have recently been included in the ACC/AHA high risk category were weakly or not associated with statin use including stroke and peripheral arterial disease.

MedicalResearch: Were any of the findings unexpected?

Dr. Johansen: Given that statin use has long been identified as one of the cornerstones of management of individuals with coronary artery disease, we were surprised by the low rates of use. The association between hyperlipidemia and statin use was not unexpected given the long history of focusing on lipid values instead of cardiovascular risk. However, the strength of the association was larger than we had expected.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Johansen: The study supports the recent ACC/AHA guideline’s the move away from focusing so much attention on treating to target LDL to focusing on global cardiovascular risk. Hopefully, with the shift away from the treat to target focus more high-risk individuals will initiate or continue using statins. Clinicians should also focus on educating patients (especially high-risk) on the importance of regularly taking statins regardless of their cholesterol values as this will reduce their risk of future cardiovascular events.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Johansen: More research is needed to determine why individuals are not taking statins. We were not able to identify where the system broke down. This would include physicians not prescribing, patients not starting or continuing, or overall access to care problems.

Citation:

Cardiovascular Risk and Statin Use in the United States
Michael Edward Johansen, Lee A. Green, Ananda Sen, Sheetal Kircher, and Caroline R. Richardson

Ann Fam Med May/June 2014 12:215223; doi:10.1370/afm.1641