High Levels of Statin non-acceptance shown to persists

Abstract

Heart disease is the leading cause of death worldwide and statin therapy has consistently shown in multiple landmark studies to reduce cardiovascular events and death. Despite the strength of evidence of its benefits, clinicians face many patients who are reluctant to start statin therapy. A new study published in the JAMA Network Open, by investigators from Brigham and Women's Hospital has conducted the first population-based study on patients’ non-acceptance of statin therapy recommendations. The study focused on high-risk patients who either had coronary artery or vascular disease, diabetes, high cholesterol levels, or previous history of stroke. All of these patients were recommended statins by their physicians, by virtue of their high cardiovascular risk in order to reduce their risk of heart attack and stroke and reduce cholesterol levels. The retrospective study included more than 24,000 patients who were seen at Mass General Brigham between Jan. 1, 2000, and Dec. 31, 2018. The study found that in patients at high risk of developing cardiovascular disease, more than 20 percent of patients refused to take statin medications. Interestingly, they observed that women were more likely than men to refuse statin therapy, by about 20%, and 50 percent more likely than men to never accept the recommendation. The study also showed that all patients who refused statin therapy developed higher LDL cholesterol levels.

Unfortunately, no data is available yet on whether nonacceptance of statin therapy wold adversely affect cardiovascular event rate such as heart attacks, strokes, and death. The study highlight the importance of targeting patients who decline statins by providing further education, understanding the reasons behind non-acceptance and devise strategies to further reduce patients cardiovascular disease risk.