• Quyen Ngo-Metzger, Samuel Zuvekas, Paul Shafer, Howard Tracer, Amanda E Borsky, and Arlene S Bierman.
• From the Agency for Healthcare Research and Quality, Rockville, MD (SZ, PS, HT, AB, ASB); Department of Health Law, Policy, and Management, School of Public Health, Boston University, Boston, MA (PS); Kaiser Permanente School of Medicine (QN-M). Quyen.N.Metzger@kp.org.
• J Am Board Fam Med. 2019 Nov 1; 32 (6): 807-817.

BackgroundAtherosclerotic cardiovascular disease (ASCVD) remains the leading cause of mortality in the United States. The purpose of this study is to examine the rates of statin use for secondary prevention of ASCVD events in the United States over the last decade and determine whether disparities in the treatment of ASCVD still persist among women and racial/ethnic minorities.MethodsWe conducted a trend analysis using data from 2008 through 2016 to describe age-adjusted trends in the use of statins for secondary prevention using the Medical Expenditure Panel Survey. We also conducted a multivariable logistic regression analysis to determine whether sociodemographic characteristics are associated with statin use during the 3 years that followed the publication of the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline (2014 through 2016).ResultsThe prevalence of statin use among those with a history of ASCVD remained unchanged from 2008 through 2016. In 2014 to 2016, more than 40% of those aged 40 years and older with a history of ASCVD did not use statins, corresponding to approximately 9.5 million Americans. Increasing age and having been diagnosed with high cholesterol (odds ratio [OR], 6.22; P < .001) were associated with higher odds of statin use while being female (OR, 0.65; P < .001) or Hispanic (OR, 0.69; P = .011) were associated with lower odds of statin use.ConclusionsOur study found there was no increase in the national rates of statin use following the ACC/AHA 2013 secondary prevention guideline and the availability of generic statins. Significant gender and ethnic disparities in ASCVD treatment remained in the United States.© Copyright 2019 by the American Board of Family Medicine.

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