Statins Help Cut Cardiovascular Risks but Only 35% of Eligible Adults Use Them

A person holding a pill box.
New research finds that most adults who could benefit from taking statins to reduce their risk of cardiovascular disease aren’t taking them. Dobrila Vignjevic/Getty Images
  • Statins are an effective tool in reducing your cardiovascular risk.
  • However, a new study found that only 35% of those who are eligible are using them.
  • Experts say people may not want to take medication due to concerns about side effects.
  • Also, many people may not even know that they are at risk.
  • Your doctor can help you determine if you are a good candidate for a statin.

Statins are medications that reduce cholesterol production in the liver and help the body more effectively remove cholesterol from the blood. They can also help reduce the inflammation that contributes to clogged arteries.

However, not as many people are using them as could be, according to a study conducted by researchers at Beth Israel Deaconess Medical Center and the University of Pittsburgh.

The report — which was published on December 4, 2023, in Annals of Internal Medicine — notes that overall statin use for primary prevention of cardiovascular disease has increased over time.

But, despite a 2013 update to the American Academy of Cardiology/American Heart Association guidelines expanding statin eligibility, statin usage leveled off between 2013 and 2018 with only 35% of eligible people taking these medications.

Additionally, those who needed them most — such as those with diabetes, very high cholesterol, or a 10-year risk of cardiovascular disease above 20% — were not using them.

The study’s authors suggest that new efforts to get these drugs into the hands of the people who could benefit from them are needed.

Why are people who are eligible for statins not using them?

Dr. David Beatty — a general practitioner in Essex, England who was not involved in the study — said there were several reasons that people might not be taking a statin even though they were eligible and might be helped by it.

“Many people have never had a blood cholesterol test done,” he explained. “Heart disease is perceived as a problem affecting the middle-aged and elderly.

“In reality,” said Beatty, “the unhealthy lifestyle adopted in our younger years is causing the arteries to gradually fur up. The arterial blockage, due to atherosclerosis, only reaches a critical level later in life.”

Beatty additionally pointed to the fact that assessing an individual’s need for a statin is a complicated process.” [I]t’s not simply a case that we treat everyone with cholesterol above a certain figure,” he said.

Another reason, said Beatty, is that people don’t generally want to take a pill for the rest of their lives, especially when they are feeling fine at the time.

“Doctors can only explain the risks and benefits — we can’t force someone to take a drug they refuse to take,” he said.

Beatty added that many are reluctant to take a pill due to potential side effects.

“Side effects can occur with statins (as with any medication) but they nearly always go away if the drug is stopped,” he explained. “Long-term irreversible complications are, fortunately, rare.”

Beatty concluded by stating that lifestyle changes like diet and exercise, which many people want to try in lieu of taking medication, can often improve cholesterol. However, these lifestyle modifications can be difficult to maintain and people revert to their previous habits causing cholesterol to rise again.

How effective are statins at reducing cardiovascular disease risks?

Dr. Jim Liu, a cardiologist at The Ohio State University Wexner Medical Center, said, “Statins have been around for a long time, and they remain one of the most important and effective ways to reduce cardiovascular risk.”

According to Liu, they have been shown to lower the risk of heart attack, stroke, and death with an estimated 10% to 30% reduction in relative risk.

“This also means that a person starting out with a high risk would benefit much more versus someone who is already at low risk,” he explained.

How can people find out if they are eligible to take a statin?

The easiest way to find out if you are eligible for a statin, according to Liu, is to simply speak with your doctor or other healthcare provider.

“If someone has had a heart attack, stroke, or significant coronary artery disease,” he said, “then they should be on a statin to prevent future recurrence or progression of disease.”

However, even if you don’t fall into one of these categories, you may still benefit from being on a statin, per Liu.

“For example, some of the groups that are known to benefit from statin therapy include diabetics, having very high cholesterol with LDL >190, having a high coronary artery calcium score, or having an elevated estimated risk of cardiovascular disease over the next 10 years,” he said.

Another way to determine if you are a candidate is to use a risk calculator.

“There are calculators which work out your 10-year risk of a cardiac event,” explained Beatty.

He did note, however, that some calculators do have limitations. For example, some are not appropriate if you already have heart disease, and some only cover particular age groups.

Beatty pointed to the American Heart Association (AHA) calculator as one that you can use. You will need to have access to your cholesterol values as well as your systolic blood pressure in order to use it. You can also use the calculator to obtain an updated assessment of your risk if you were to begin using a statin.

Takeaway

Statins are an important way to lower your cardiovascular risk, with estimates indicating that they can reduce the risk of heart attack, stroke, or death by 10%-30%.

However, despite revised guidelines making more people eligible for them, only 35% of eligible people actually use them.

Many people simply don’t know they are at risk. Yet others are reluctant to use medications, often because they fear having side effects or think they are young and don’t need them.

It’s easy to find out if you are eligible for a statin. Simply speak with your doctor; or, if you know your cholesterol numbers and your blood pressure, try using a risk calculator like the one provided by the AHA.

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