Prevalence of the American College of Cardiology/American Heart Association statin eligibility groups, statin use, and low-density lipoprotein cholesterol control in US adults using the National Health and Nutrition Examination Survey 2011-2012.
The 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline identifies 4 statin-eligible groups: (1) known atherosclerotic cardiovascular disease (ASCVD) aged ≥21 years, (2) low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL (4.9 mmol/L) aged ≥21 years, (3) diabetes mellitus aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L), or (4) ≥7.5% 10-year ASCVD risk aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L).



We examined the number of statin-eligible US adults, statin use, LDL-C goal attainment, and adherence to lifestyle management.



We identified subjects from the US National Health and Nutrition Examination Survey 2011-2012 in the 4 statin-eligible groups, proportion on statin, proportion at recommended LDL-C levels using National Lipid Association goals (<70 mg/dL [1.8 mmol/L] for very high risk and <100 mg/dL [2.6 mmol/L] for others), and adherence to lifestyle measures.



Of 5206 adults (representing 219 million), 1677 adults representing 62.6 million adults fit into 1 of the 4 statin-eligible groups. Statin use was 63.7% for the ASCVD, 61.4% for the LDL-C ≥ 190 mg/dL (4.9 mmol/L), 43.2% for the diabetes mellitus, and 27.2% for the 10-year risk ≥7.5% groups. Of those on statins with LDL-C measured, 79.7%, 98.0%, 42.3%, and 46.8% were not at LDL-C goal. Adherence to recommended <6% calories from saturated fat ranged from 3.3% to 6.4% and ≥40 minutes of physical activity ≥3 times a week from 54.7% to 65.1% across statin-eligible groups.



Many US adults eligible to receive statins based on American College of Cardiology/American Heart Association guidelines are not taking statins, and LDL-C levels still remain suboptimal.
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA. Electronic address: ndwong@uci.edu.
Nathan D
ND
Wong
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
Daphnee
D
Young
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
Yanglu
Y
Zhao
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
Huy
H
Nguyen
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA.
Jared
J
Caballes
Global Health Economics and Outcomes Research, Sanofi, Bridgewater, NJ, USA.
Irfan
I
Khan
Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
Robert J
RJ
Sanchez
D000328:Adult; D000572:American Heart Association; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D015444:Exercise; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012306:Risk; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiovascular disease; Cholesterol; Dyslipidemia; Goal attainment; Guidelines; Statins