Salt Lake City, UT—Pharmacists fill a lot of prescriptions for statins, but despite widespread use of the cholesterol-lowering drugs, they remain underprescribed in some situations, according to a new study.

Specifically, a new report in JAMA Cardiology describes how statin use for primary prevention of ASCVD was low among all race and ethnicity groups, regardless of risk. Black and Hispanic adults had the lowest use, according to University of Utah–led authors, who noted, “Improvements in access to care may promote equitable use of primary prevention statins in black and Hispanic adults.”

The study team sought to determine the prevalence of statin use for ASCVD primary prevention by race and ethnicity according to 10-year risk. The cross-sectional analysis of the National Health and Nutrition Examination Surveys represented 39.4 million U.S. adults after applying sampling weights.

“The findings in this study indicate that racial and ethnic disparities in the use of statins for primary prevention across all strata of ASCVD risk are associated with poor access to care among individuals of self-reported Black and Hispanic race and ethnicity,” the researchers advise.

That is especially concerning because black and Hispanic adults, as compared with white adults, have a greater burden of ASCVD in the United States, according to the study. The authors suggest, “Inclusion of race in guidance for statin indication may lead to decreased disparities in statin use.”

The study team performed the serial, cross-sectional analysis in May 2022, using data from the National Health and Nutrition Examination Survey, a nationally representative sample of health status in the U.S., from 2013 to March 2020 (limited cycle due to the COVID-19 pandemic). Included were 3,417 participants aged 40 to 75 years without ASCVD, diabetes, low-density lipoprotein cholesterol levels 190 mg/dL or greater, and with data on medication use.

The participants had a mean age of 61.8 years and had a weighted percentage of 62.2% men. White participants made up a weighted percentage of 73%, followed by black, 12.7%; Hispanic, 10.1%; and Asian 4.2%.

“Compared with white participants, statin use was lower in black and Hispanic participants and comparable among Asian participants in the overall cohort (Asian, 25.5%; black, 20.0%; Hispanic, 15.4%; white, 27.9%) and within ASCVD risk strata,” the study pointed out. “Within each race and ethnicity group, a graded increase in statin use was observed across increasing ASCVD risk strata. Statin use was low in the highest risk stratum overall with significantly lower rates of use among black (23.8%; prevalence ratio [PR], 0.90; 95% CI, 0.82-0.98 vs. white) and Hispanic participants (23.9%; PR, 0.90; 95% CI, 0.81-0.99 vs. white).”

The authors note that higher statin use was associated with routine healthcare access and health insurance, among other factors. Prevalence of statin use did not meaningfully change over time by race and ethnicity or by ASCVD risk stratum, they add.

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