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Trends in statin use for the primary prevention of atherosclerotic cardiovascular disease among US adults by demographic characteristics, 1999–2020

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Abstract

Purpose

Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality worldwide. Statins, which are effective in preventing ASCVD, are underused, particularly for primary prevention. This study examined trends in statin use for primary ASCVD prevention from 1999 to 2020, focusing on demographic variations.

Methods

Utilizing data from the National Health and Nutrition Examination Survey, the present study includes individuals aged 18 years and older who had a greater than 10% risk of ASCVD over 10 years, and excluded patients with existing ASCVD. Subgroup analyses by demographic categories were performed. We calculated the changes in statin usage and used linear and quadratic tests to assess the linear and nonlinear trends in those changes.

Results

A total of 10,037 participants were included. Statin usage increased from 16.16% in 1999 to 36.24% in 2010, and 41.74% in 2020 (quadratic P-value < 0.001). In the 18–44 years age group, statin usage increased from 2.52% in 1999 to 8.14% in 2020 (linear P-value = 0.322), showing no significant linear trend. In the “never-married” group, statin usage increased from 19.16% in 1999 to 30.05% in 2020 (linear P-value = 0.256).

Conclusion

Statin usage has shown a positive trend among populations requiring primary prevention for ASCVD. Currently, health policies are proving effective. However, the overall statin usage rate remains less than 50%. Additionally, young and never-married individuals should also receive special attention regarding statin usage as primary treatment for ASCVD.

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Code availability

Code sharing is not applicable to this article as no codes were generated or analyzed during the current study.

Data availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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Acknowledgements

We express our gratitude to the staff at the National Center for Health Statistics at the CDC for their diligence in data collection and release.

Funding

This study was supported by Sichuan Provincial Cadre Health Research Project, China (Sichuan Ganyan ZH2024-101), and by 1·3·5 project for disciplines of excellence–Clinical Research Incubation Project, West China Hospital, Sichuan University (Grant number: 2021HXFH061, Sichuan, China).

Author information

Authors and Affiliations

  1. Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, China

    Junwen Wang, Yuyang Ye, Xuefeng Chen, **nru Hu & Yong Peng

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Contributions

WJW and PY were responsible for study concept and design, statistical analysis and interpretation of the data, and drafting and redrafting of the manuscript. WJW and YYY were responsible for statistical analysis. WJW and CXF were responsible for data acquisition. WJW and PY contributed to critical revision of the manuscript. WJW, HXR, and PY prepared Figs. 1, 2, and 3. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yong Peng.

Ethics declarations

Ethics approval and consent to participate

The Institutional Review Board of the National Center for Health Statistics approved this study. All participants provided written informed consent.

Competing interests

The authors declare no competing interests.

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Highlights

• The utilization rate of statins among individuals needing primary prevention of ASCVD has significantly increased.

• There was no notable improvement trend among never-married individuals or those aged 18–44 years.

• Current health policies have been effective at increasing statin use for primary prevention in patients at risk for ASCVD, but the overall usage rate remains below 50%.

Supplementary Information

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Supplementary file1 (DOCX 79.0 KB)

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Wang, J., Ye, Y., Chen, X. et al. Trends in statin use for the primary prevention of atherosclerotic cardiovascular disease among US adults by demographic characteristics, 1999–2020. Eur J Clin Pharmacol (2024). https://doi.org/10.1007/s00228-024-03699-1

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