A recent study published in the Annals of Internal Medicine has shed light on a concerning trend in the use of statin drugs, a key preventive therapy for adults at risk of cardiovascular diseases. Despite a general increase in statin use among adults aged 20 and older between 1999 and 2018, the research highlights a plateau in the past five years, with only 35% of eligible adults receiving these crucial medications. Â
Statin drugs play a pivotal role in lowering blood cholesterol levels, thereby reducing the risk of heart attack and stroke. The recommended criteria for statin use include individuals with LDL cholesterol levels of 190 mg/dL or higher, as well as adults aged 40 to 75 with LDL levels of 70 mg/dL or higher who also have diabetes or are at high risk of cardiovascular events. Â
One of the key factors contributing to the low uptake of statins is the prevalence of misinformation regarding their side effects. Experts have pointed out a negative stigma associated with statins, with fear of side effects such as muscle pain and weakness deterring potential beneficiaries. However, doctors emphasize that these side effects are relatively rare and can often be addressed by switching to an alternative statin within the same drug class. Â
Dr. Michael Broukhim, an interventional cardiologist at Providence Saint John’s Health Center in California, underscores the impact of online misinformation, stating that misconceptions limit statin uptake among the general population. Patients may be influenced by unfounded claims, including the belief that cholesterol is not crucial in reducing heart disease risk, or that statins may cause liver damage and dementia. Â
Dr. Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute, adds, “Statins are inexpensive and available in generic form and are one of the most cost-effective treatments we have for fighting the number one killer in America: heart disease.” Beyond misinformation, the study reveals medical barriers that hinder access to statin therapy.
The complexity introduced by expanded guidelines in 2013 by the American College of Cardiology and the American Heart Association Task Force has resulted in lower statin use. The guidelines require a multistep risk calculation, and many clinicians find it challenging to incorporate these calculations into their practice due to factors such as limited time and competing patient priorities. Â
The study emphasizes the need for improved identification of individuals who could benefit from statin therapy and highlights the potential of electronic health record tools to calculate cardiovascular risk.
Despite these challenges, the researchers underscore the critical role of statins in preventing heart disease, urging both healthcare providers and the public to be better informed about their benefits and risks. Efforts to dispel misinformation and streamline the decision-making process for statin prescriptions are essential to bridge the gap and ensure that eligible individuals receive this frontline preventive therapy.Â
Journal Reference Â
Kim, C. J., Sussman, J. B., Mukamal, K. J., Eades, M., & Anderson, T. S. (2023). Annals of Internal Medicine. doi:10.7326/m23-1915Â
