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High Cholesterol Undertreated in Hispanic-Americans

FACT: Up to two-thirds of eligible Hispanics are not taking statins.

A new study shows that there is a large gulf between the amount of Hispanic-Americans/Latino-Americans actually taking statins and the amount of Hispanic-Americans who are eligible to take them.

The study authors looked at data from 16,415 adult Hispanic-Americans/Latino-Americans. They looked at data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), which is a large multicenter U.S.-based study. They found that 32.1% were eligible for statins under 2013 ACC/AHA guidelines, and 20.5% were eligible for statin therapy according to the NCEP/ATP III guidelines. However, only 10.4% were actually on statin therapy – this shows that they are undertreated no matter which method is used to determine eligibility for statin pharmacotherapy. The research also shows that the 2013 ACC/AHA guidelines have increased overall statin eligibility for this patient population.

There are many reasons why this group might be undertreated, including the socioeconomic causes. One clinical reason is that statins may increase the risk of type 2 diabetes in patients. Because Hispanics/Latinos in the United States are more prone to this form of diabetes, some clinicians may use that as a factor in their prescribing decision-making.

The results of this study suggest that clinicians need to find strategies to increase statin use among Hispanics/Latinos in the United States. Otherwise, this patient population may see higher incidences of cardiovascular disease and sequelae. Finally, other similar studies about statin usage should be performed on different ethnic or minority groups to identify gaps in usage. These studies could reveal how much the new guidelines have influenced statin therapy among different patient populations.

The proportion of statin-eligible adults grew among older adults according to both recommendations and among males in the ACC/AHA guidelines. There was also an increase in eligibility for statin therapy in middle-aged adults.

Researchers said regardless of the definition for statin eligibility, Hispanics are largely undertreated.

Practice Pearls:

  • A study suggests that up to 2/3 of Hispanics who need to be treated with statins are not.
  • The gap between treatment and eligibility for treatment is larger when using the 2013 ACC/AHA guidelines, which expanded eligibility for many patients.
  • Future studies should identify other populations which are undertreated with statins.

Qureshi WT. American Heart Association 2015 Meeting Report Abstract 1345. Press release: 9 November 2015.