PCV73 Risk Factors Associated with Statin Use Among Adult Nhanes Participants with Ascvd

Abstract

To determine the prevalence of atherosclerotic cardiovascular disease (ASCVD) and to assess risk factors associated with statin use among US adults with ASCVD. Using the National Health and Nutrition Examination Survey (NHANES) data over three exam cycles (2011-16), ASCVD prevalence was calculated among adult participants (20+ years). ASCVD included myocardial infarction (MI), coronary heart disease (CHD), stroke and angina and was obtained via a self-report questionnaire. Current statin use (monotherapy and combination therapy) was obtained from questionnaires and a medication inventory. Multivariate logistic regression was used to examine the association of risk factors with statin use. All analyses accounted for the NHANES complex sampling design. Among US adults in NHANES, 7.8% of participants reported having ASCVD, with 3.3% reporting MI, 3.4% CHD, 2.8% stroke and 2.1% angina. Among those with ASCVD, 62.9% were taking statins, of which only 27% were at LDL-C <70 mg/dL. In adjusted models, participants reporting a history of CHD or type II diabetes had 2.58 (95% CI (1.68, 3.97); p<0.001 and 1.60 (1.03, 2.49); p=0.04 times greater odds of statin use, respectively, as well as those reporting a family history of MI (1.46 (1.01, 2.13); p=0.05). Increasing age categories (45-64 and 65+ versus <45) were significantly associated with approximately 3.5 times higher odds of taking statins (p=0.002 and p=0.004, respectively). Hispanic ethnicity (versus non-Hispanic white; 0.54 (0.34, 0.86), p=0.01)) and female sex (versus male; 0.61 (0.40, 0.92), p=0.02) were all associated with significantly lower odds of statin use. Over half of US adults who reported having ASCVD were taking statins, yet only one-fourth of those were at goal. Factors significantly associated with statin use included demographic, comorbidities, and healthcare-related factors. Greater efforts should be made to adhere to American Heart Association/American College of Cardiology guidelines regarding statin use for all individuals with existing ASCVD.