Cholesterol treatment with statins: Who is left out and who makes it to goal?
Open Access
- 17 March 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Health Services Research
- Vol. 10 (1), 68
- https://doi.org/10.1186/1472-6963-10-68
Abstract
Background Whether patient socio-demographic characteristics (age, sex, race/ethnicity, income, and education) are independently associated with failure to receive indicated statin therapy and/or to achieve low density lipoprotein cholesterol (LDL-C) therapy goals are not known. We examined socio-demographic factors associated with a) eligibility for statin therapy among those not on statins, and b) achievement of statin therapy goals. Methods Adults (21-79 years) participating in the United States (US) National Health and Nutrition Examination Surveys, 1999-2006 were studied. Statin eligibility and achievement of target LDL-C was assessed using the US Third Adult Treatment Panel (ATP III) on Treatment of High Cholesterol guidelines. Results Among 6,043 participants not taking statins, 10.4% were eligible. Adjusted predictors of statin eligibility among statin non-users were being older, male, poorer, and less educated. Hispanics were less likely to be eligible but not using statins, an effect that became non-significant with adjustment for language usually spoken at home. Among 537 persons taking statins, 81% were at LDL-C goal. Adjusted predictors of goal failure among statin users were being male and poorer. These risks were not attenuated by adjustment for healthcare access or utilization. Conclusion Among person's not taking statins, the socio-economically disadvantaged are more likely to be eligible and among those on statins, the socio-economically disadvantaged are less likely to achieve statin treatment goals. Further study is needed to identify specific amenable patient and/or physician factors that contribute to these disparities.Keywords
This publication has 45 references indexed in Scilit:
- Socioeconomic Status and Coronary Heart Disease Risk PredictionJAMA, 2008
- Associations of Acculturation and Socioeconomic Status With Subclinical Cardiovascular Disease in the Multi-Ethnic Study of AtherosclerosisAmerican Journal of Public Health, 2008
- Differential use of available genetic tests among primary care physicians in the United States: results of a national surveyGenetics in Medicine, 2008
- Screening, Treatment, and Control of Hypertension in US Private Physician Offices, 2003–2004Hypertension, 2008
- Under Utilization of Surveillance Mammography among Older Breast Cancer SurvivorsJournal of General Internal Medicine, 2007
- Use of statins and beta-blockers after acute myocardial infarction according to income and educationJournal of Epidemiology and Community Health, 2007
- Race/Ethnicity and Nonadherence to Prescription Medications Among Seniors: Results of a National StudyJournal of General Internal Medicine, 2007
- Predictors of Adherence to Statins for Primary PreventionCardiovascular Drugs and Therapy, 2007
- Are Minority Children the Last to Benefit from a New Technology?Medical Care, 2006
- National Trends in Statin Use by Coronary Heart Disease Risk CategoryPLoS Medicine, 2005