Statins Underused in Veterans with Severely Elevated Cholesterol Interview with:

Fatima Rodriguez, MD, MPH Division of Cardiovascular Medicine Stanford University Stanford, CA 94305-5406,

Dr. Rodriguez

Fatima Rodriguez, MD, MPH
Division of Cardiovascular Medicine
Stanford University
Stanford, CA 94305-5406, What is the background for this study? What are the main findings?

Response: Individuals with LDL-cholesterol levels above 190mg/dL are often underdiagnosed and undertreated, yet remain at high-risk of cardiovascular disease. In a national sample of veterans, we identified over 60,000 patients who met criteria for uncontrolled, severe hypercholesterolemia based on an index LDL-C value ≥190mg/dL. We found that only half of these high-risk patients are being treated with statins, and less than 10% are on high-intensity statin therapy as recommended by the 2013 ACC/AHA guidelines. We also found that both older and younger patients were less likely to be treated with statins. Women were less likely to be treated with statins, whereas minority groups and those with a diagnosis of hypertension were more likely to be treated. Disparities in use of statins were also noted by geographic region and hospital teaching status. What should readers take away from your report?

Response: Veterans with severe hypercholesterolemia underuse statins and few are on guideline-recommended high-intensity statins. Significant public health efforts are needed to meet guideline recommended care for these high-risk patients. What recommendations do you have for future research as a result of this work?

Response: Future studies should try to understand why patients with severe hypercholesterolemia remain undertreated, despite compelling evidence that use of high-intensity statins significantly attenuates cardiovascular risk. 


Frequency of Statin Use in Patients with Low-Density Lipoprotein Cholesterol ≥ 190mg/dL From the Veterans Affairs Health System

lFatimaRodriguezMD, MPHaJoshua W.KnowlesMD, PhDaDavid J.MaronMDaSalim S.ViraniMD, PhD Paul A.HeidenreichMD, MSac
The American Journal of Cardiology
Available online 7 June 2018 

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Last Updated on June 14, 2018 by Marie Benz MD FAAD