Although previous studies have tracked statin use on a smaller scale, Ma said this study is the first to examine how statin therapy varies according to the risk of heart disease among U.S. outpatients.
The researchers examined two national databases that tracked outpatient visits to hospitals and physician offices between 1992 and 2002, and the types of medications that were either continued or prescribed during those visits. They then correlated the results with the number of patients who had been diagnosed with high cholesterol levels and whose risk for heart disease was categorized as either high (already having either heart disease, stroke, peripheral vascular disease or diabetes), moderate (having two or more risk factors for heart disease, such as high blood pressure, obesity and cigarette smoking) or low (no more than one risk factor).
"We looked at people who were likely to benefit the most from these drugs and we found a wide therapeutic gap," Ma said.
Among patients with high cholesterol in the moderate- and high-risk groups, the researchers found that fewer than half of the patient visits were associated with statin use in 2002. Among the high-risk group, statin use rose from 14 percent of patient visits in 1992 to 50 percent in 2002. For those at moderate risk, statin use went from 9 percent of patient visits in 1992 to 44 percent in 2002.
While encouraged that statin has increased, "it's disconcerting that the magnitude of the increase is much smaller than expected," Ma said. "The rate of use falls significantly short of the latest recommendations
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Contact: Susan Ipaktchian
susani@stanford.edu
650-725-5375
Stanford University Medical Center
30-May-2005