Prevalence of Statin Use for Primary Prevention of Atherosclerotic Cardiovascular Disease by Race, Ethnicity, and 10-Year Disease Risk in the US: National Health and Nutrition Examination Surveys, 2013 to March 2020
Abstract
Importance The burden of atherosclerotic cardiovascular disease (ASCVD) in the US is higher among Black and Hispanic vs White adults. Inclusion of race in guidance for statin indication may lead to decreased disparities in statin use. Objective To evaluate prevalence of primary prevention statin use by race and ethnicity according to 10-year ASCVD risk. Design, setting, and participants This serial, cross-sectional analysis performed in May 2022 used data from the National Health and Nutrition Examination Survey, a nationally representative sample of health status in the US, from 2013 to March 2020 (limited cycle due to the COVID-19 pandemic), to evaluate statin use for primary prevention of ASCVD and to estimate 10-year ASCVD risk. 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 were included. Exposures Self-identified race and ethnicity (Asian, Black, Hispanic, and White) and 10-year ASCVD risk category (5%- Main outcomes and measures Prevalence of statin use, defined as identification of statin use on pill bottle review. Results A total of 3417 participants representing 39.4 million US adults after applying sampling weights (mean [SD] age, 61.8 [8.0] years; 1289 women [weighted percentage, 37.8%] and 2128 men [weighted percentage, 62.2%]; 329 Asian [weighted percentage, 4.2%], 1032 Black [weighted percentage, 12.7%], 786 Hispanic [weighted percentage, 10.1%], and 1270…
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Currently, lipid-lowering therapies are underutilized in high-risk primary prevention patients, particularly women and patients from racial and ethnic minority populations.
“Currently, lipid-lowering therapies are underutilized in high-risk primary prevention patients, particularly women and patients from racial and ethnic minority populations.[8][9][10]”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [10]
These findings emphasize the potential value of lipid-modulating therapy in patients who have had no prior cardiovascular event but who have a high risk for a first event, a population that is currently undertreated.
“These findings emphasize the potential value of lipidmodulating therapy in patients who have had no prior cardiovascular event but who have a high risk for a first event, a population that is currently undertreated.[8][9][10][15][16][17][18]”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [10]
Cites
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Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients
Nissen, S. E., Menon, V., Nicholls, S. J., Brennan, D., Laffin, L., Ridker, P., Ray, K. K., Mason, D., Kastelein, J. J. P., Cho, L., et al. (2023) · JAMA · doi:10.1001/jama.2023.9696 · Cited by 146 · see citing works
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Self-citationEvidence-based SGLT2 inhibitor and GLP-1 receptor agonist use by race in the VA healthcare system
Bolden, D. M., Richardson, V., Salahuddin, T., Henderson, K., Hess, P. L., Raghavan, S., Saxon, D. R., Ho, P. M., Waldo, S. W., & Schwartz, G. G. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.100966 · Cited by 4 · see citing works
- Authors
- Jacobs, J. A., Addo, D. K., Zheutlin, A. R., Derington, C. G., Essien, U. R., Navar, A. M., Hernandez, I., Lloyd-Jones, D. M., King, J. B., Rao, S., Herrick, J. S., Bress, A. P., & Pandey, A.
- Affiliations
- Intermountain Healthcare (US)
- University of Utah (US)
- University of California, Los Angeles (US)
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas
- University of California San Diego (US)
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Jacobs, Joshua A.
- Pandey, Ambarish
- ORCID
- Venue
- JAMA Cardiology
- Publisher
- American Medical Association (AMA)
- Published
- 2023-05-01
- Volume
- 8
- Issue
- 5
- Pages
- 443
- ISSN
- 2380-6583 (ISSN-L)
- OpenAlex
- W4353016767
- Cited by
- 97
- References
- 3
- Citations by year
- 2026: 28 · 2025: 34 · 2024: 24 · 2023: 11
- FWCI
- 25.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R38HL143605)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- statin use, primary prevention, atherosclerotic cardiovascular disease, racial disparities, ethnic disparities, 10-year cardiovascular risk, Black people, Hispanic adults, Asian adults, medication adherence, NHANES, cardiovascular risk stratification, health equity, United States adults
- MeSH terms
- COVID-19, Adult, Cardiovascular Diseases, Cross-Sectional Studies, Ethnicity, Female, Humans, Male, Middle Aged, Nutrition Surveys, Primary Prevention, Prevalence, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Atherosclerosis, Pandemics
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