Abstract 072: Statin Eligibility And Use For Primary Prevention Among US Adults Across Strata Of Atherosclerotic Cardiovascular Disease Risk

Abstract

Introduction: In 2019, primary prevention guidelines broadened consideration for statin eligibility among those at borderline to intermediate risk for atherosclerotic cardiovascular disease (ASCVD) in the presence of a risk-enhancing factor (REF). However, the proportion of US adults affected by these guidelines, particularly among those estimated to be at borderline to intermediate risk for ASCVD, is unclear. Objectives: To determine the contemporary prevalence of statin use and eligibility among US adults at low, borderline, intermediate, and high ten-year risk of ASCVD in the presence of ASCVD risk-enhancing factors. Methods: We included participants age ≥ 20 years from the National Health and Nutrition Examination Survey from 2015-2018. Ten-year ASCVD risk was classified based on the Pooled Cohort Equations as: low <5%, borderline 5 - <7.5%, intermediate ≥7.5 - <20%, and high ≥20%. The weighted prevalence of statin use was calculated in each risk category. Weighted logistic regression assessed the association between presence of risk-enhancing factors (see Table) with statin use across strata of ASCVD risk. Results: Of 1350 participants (representing 37,705,137 US adults), 46% were female and mean (SE) age was 58 (0.6) years. Of these 39%, 15%, 31% and 15% were in the low, borderline, intermediate, and high ASCVD risk groups, respectively. Among adults at borderline and intermediate ASCVD risk, 89% and 90% had at least one risk-enhancing factor, respectively. Of these adults, 88% and 91% were not on a statin, respectively. Odds of statin use for individuals with risk-enhancing factors is shown in the Table. Conclusion: A large proportion of adults with borderline/intermediate ASCVD risk were not taking a statin despite a high prevalence of risk-enhancing factors.