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Abstract 11668: Trends in Statin Use for Primary Prevention by Race, Ethnicity, and ASCVD Risk in the US: National Health and Nutrition Examination Surveys 2013-2020
Jacobs JA, Daniel K, Addo DK, Alexander R, Zheutlin AR, Derington CG, Essien UR, Navar AM, Hernandez I, Donald M, Lloyd-Jones DM, King JB, Rao S, Herrick JS, Bress AP, Pandey A. Abstract 11668: Trends in Statin Use for Primary Prevention by Race, Ethnicity, and ASCVD Risk in the US: National Health and Nutrition Examination Surveys 2013-2020. [Abstract]. Circulation. 2022 Oct 30; 146(Suppl_1):https://doi.org/10.1161/circ.146.suppl_1.11668.
ntroduction: The burden of ASCVD is higher among non-Hispanic Black (NHB) and Hispanic vs. non-Hispanic White (NHW) US adults, potentially due to differences in use of preventive medications such as statins. We evaluated patterns in statin use for primary prevention by self-identified race/ethnicity (NHB, NHW, and Hispanic) according to 10-year ASCVD risk using the Pooled Cohort Equations.
Methods: This serial, cross-sectional analysis included NHANES participants from 2013-2020 age 40-75 years without ASCVD, diabetes, LDL 190 mg/dL, or missing data for estimation of 10-year ASCVD risk. Statin use was determined by interviewer pill bottle review. Poisson regression estimated adjusted prevalence ratios for statin use associated with race/ethnicity and ASCVD risk categories (5- < 7.5%, 7.5- < 20%, and 20%); all analyses incorporated NHANES survey weights.
Results: A total of 3,088 participants representing 37.8 million US adults (mean age 62 y, 38% women, 13% NHB, 11% Hispanic, 76% NHW) were included. Overall, statin use was lower in NHB (20.0%) and Hispanic (15.4%) than NHW adults (27.9%). Within all ASCVD risk categories, the odds of statin use were significantly lower among NHB and Hispanic vs. NHW adults (Figure). Within each race/ethnicity group, the use of statins increased across increasing ASCVD risk strata, with a significantly greater utilization among those with ASCVD risk 20% (vs. ASCVD risk 5- < 7.5%) (Figure). Statin use was stable over time and within race/ethnicity and risk strata (p > 0.05 for all NHANES cycles).
Conclusions: Overall statin use for primary prevention based on 10-year ASCVD risk was low in all race/ethnicity groups regardless of predicted ASCVD risk, though undertreatment was most severe in NHB and Hispanic adults. Improvements in equitable utilization of statins for primary prevention in Black and Hispanic adults are needed to address disparities in ASCVD.