Statins Underused in Younger Adults with Dyslipidemia, Despite Guidelines

Despite guidelines, a majority of younger adults with severe dyslipidemia do not receive statins, according to a new research letter.

In order to examine rates of statin prescriptions and identify treatment gaps in a real-world contemporary setting, researchers conducted an analysis of data from a large database encompassing inpatient and outpatient encounters from 360 medical centers. They included all patients who were between age 20 and 75 years old who had both LDL-C and pharmacy records reported between July 1, 2013 and July 31, 2016. Patients with one or more statin indications were identified and organized into 3 groups: patients with LDL-C of 190 mg/dL or greater, patients with diabetes and LDL-C greater than 70 mg/dL, and patients with atherosclerotic cardiovascular disease (ASCVD).
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Overall, of the 2,884,260 patients, 109,980 (3.8%) had an LDL-C of 190 mg/dL or greater. Rate of statin prescription for patients with severe dyslipidemia but without diabetes or established ASCVD was 66%. Even in patients with LDL-C greater than 250 mg/dL, 25% were still not prescriped a statin. The rate of statin prescription improved in those with LDL-C levels of 190 mg/dL or greater who also had diabetes or ASCVD (84%) and in those with all 3 conditions (93%).

“Notably, statin prescription rates for patients with dyslipidemia varied sharply by age, with significantly lower rates in younger patients,” the authors wrote.

They noted that guidelines recommend against using ASCVD risk calculators in patients aged 21 and older with primary severe dyslipidemia, and that doing so could lead to deferral of statin therapy.

—Michael Potts

Reference:

Al-Kindi SG, DeCicco A, Longenecker CT, et al. Rate of statin prescription in younger patients with severe dyslipidemia [published online January 4, 2016]. JAMA. doi:10.1001/jamacardio.2016.5162.