title: Population health impact of statin treatment in Canada.
abstract: BACKGROUND
  Statins are prescribed to treat dyslipidemia (abnormal amount of lipids such as cholesterol and/or fat in the blood) and reduce cardiovascular disease (CVD) risk. This study describes the CVD risk profile of Canadians aged 20 to 79, compares current treatment patterns with guideline recommendations, and investigates the population health impact of statin treatment.
  
  
  METHODS
  The baseline CVD risk of the Canadian population aged 20 to 79 was estimated by applying population-weighted risk factor data from the 2007 to 2011 Canadian Health Measures Survey (CHMS) to the Framingham Risk Score. Estimates of statin effectiveness from the literature were applied to baseline risk to assess the number of CVD events avoided owing to actual (CHMS-reported) and recommended (2012 Canadian Cardiovascular Society guidelines) statin treatment.
  
  
  RESULTS
  An estimated 2.8 million Canadian adults (about 1 in 10) were treated with statin drugs. The mean 10-year CVD risk of those treated was 27%. Assuming optimal adherence, it was estimated that statin treatment avoided around 18,900 CVD events annually and yielded a number-needed-to-treat (average number of patients treated to prevent one additional CVD event) of 15 over 10 years. In comparison, 6.5 million Canadian adults (about 1 in 4) were recommended for treatment under the 2012 guidelines. The mean 10-year CVD risk of those recommended for treatment was 24%, which translates into a number-needed-to-treat of 17 over 10 years, or approximately 38,600 CVD events avoided annually. The largest gaps in treatment and potential CVD events avoided were among people at high and intermediate risk for CVD.
  
  
  CONCLUSIONS
  Canadians' CVD risk could be lessened with enhanced targeting of statin treatment to individuals at high and intermediate risk. Such a strategy would likely require additional investments.
authors.affiliation: Health Analysis Division, Statistics Canada, Ottawa, Ontario.
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Hennessy
authors.affiliation: The Ottawa Hospital Research Institute and the Bruyere Research Institute.
authors.forename: Peter
authors.initials: P
authors.lastname: Tanuseputro
authors.affiliation: The Ottawa Hospital Research Institute and the Institute for Clinical Evaluative Sciences.
authors.forename: Meltem
authors.initials: M
authors.lastname: Tuna
authors.affiliation: The Ottawa Hospital Research Institute.
authors.forename: Carol
authors.initials: C
authors.lastname: Bennett
authors.affiliation: The Ottawa Hospital Research Institute and the Bruyere Research Institute.
authors.forename: Richard
authors.initials: R
authors.lastname: Perez
authors.affiliation: Public Health Agency of Canada.
authors.forename: Margot
authors.initials: M
authors.lastname: Shields
authors.affiliation: Institute for Clinical Evaluative Sciences and the Schulich Heart Centre, Sunnybrook Health Sciences Centre.
authors.forename: Dennis T
authors.initials: DT
authors.lastname: Ko
authors.affiliation: Institute for Clinical Evaluative Sciences and the Schulich Heart Centre, Sunnybrook Health Sciences Centre.
authors.forename: Jack
authors.initials: J
authors.lastname: Tu
authors.affiliation: Health Analysis Division, Statistics Canada, the Ottawa Hospital Research Institute, the Bruyere Research Institute, and the Institute for Clinical Evaluative Sciences.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Manuel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D050171:Dyslipidemias / Q000188:drug therapy*; D005260:Female; D062489:Health Impact Assessment / Q000379:methods*; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; clinical guidelines; risk assessment; risk reduction