Statin use for primary prevention substantially lower among Black, Hispanic adults
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Key takeaways:
- Black and Hispanic adults are less likely to use statins compared with white adults.
- Having health insurance or routine health care access was associated with increased statin use across all race groups.
Among adults with an indication for statin therapy for primary prevention, there are marked disparities in statin use by race and ethnicity groups, with the lowest use rates among Black and Hispanic adults, cross-sectional data show.
“Heart disease is the leading cause of death in the United States and statins are safe and effective for preventing heart disease,” Joshua A. Jacobs, PharmD, BCCP, a cardiology clinical pharmacist and population health sciences doctoral student with the University of Utah School of Medicine, told Healio. “We found that among those who are guideline-recommended for statin therapy for primary prevention, statin use was low overall and much lower in Hispanic and non-Hispanic Black adults vs. non-Hispanic white adults.”
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Jacobs and colleagues analyzed data from 3,417 adults aged 40 to 75 years with an LDL of 190 mg/dL or greater but without ASCVD at baseline who participated in the U.S. National Health and Nutrition Examination Survey between 2012 and 2020. Researchers evaluated statin use for primary prevention of ASCVD and estimated 10-year ASCVD risk. The mean age of participants was 61.8 years; 37.8% were women, 12.7% were Black, 4.2% were Asian and 10.1% were Hispanic. The primary outcome was prevalence of statin use, defined as identification of statin use on pill bottle review.
The findings were published in JAMA Cardiology.
Compared with white participants, statin use was lower among Black and Hispanic participants and comparable among Asian participants in the overall cohort. Statin use was 25.5% for Asian adults, 20% for Black adults, 15.4% for Hispanic adults and 27.9% for white adults.
Within each race and ethnicity group, researchers observed a graded increase in statin use across increasing ASCVD risk strata. Statin use was low in the highest risk stratum overall, with significantly lower rates of use among Black participants (23.8%; prevalence ratio = 0.9; 95% CI, 0.82-0.98) and Hispanic participants (23.9%; prevalence ratio = 0.9; 95% CI, 0.81-0.99) compared with white participants.
Researchers found that routine health care access and having health insurance were significantly associated with higher statin use in Black, Hispanic and white adults. The prevalence of statin use did not meaningfully change over time by race and ethnicity or by ASCVD risk stratum.
“Equitable use of statin therapy for prevention of heart disease is needed for Black and Hispanic adults,” Jacobs told Healio. “Improvements in access to care, such as having a routine primary care clinician and health insurance may decrease these health disparities.
The next step in research is to do community-based participatory research focusing on different implementation strategies to increase the uptake of preventative statin use among Black and Hispanic communities.”
For more information:
Joshua A. Jacobs, PharmD, BCCP, can be reached at joshua.jacobs@utah.edu; Twitter: @joshjpharmd.
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