According to a study, doctors do not offer statins to more than half of eligible patients



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The researchers interviewed 5,693 people from the Lipid Management Registry Assessment conducted by the patient and his provider, a national database of physician practices across the United States. A total of 1,511 adults did not receive statins, although they met the eligibility criteria for the drug as per 2013 guidelines from the American College of Cardiology and the American Heart Association.

A majority – 59% – of these 1,511 reported that their doctor had never offered the drug. Ten percent said they had decreased their statins after their doctor's recommendations and 30.7% had taken a statin, but had chosen to stop, according to the study published Wednesday in the Journal of the American Heart Association.

According to the study, those who say they never received a statin were more likely to be women, African American and uninsured.

Statins work by reducing the amount of "bad" cholesterol, called low-density lipoprotein or LDL. Since medications can reduce the risk of heart attacks and strokes, the American Heart Association and the American College of Cardiology recommend doctors to use a risk calculator on 10 years to determine which patients can benefit from such treatment.
More than 78 million Americans, or just over a third of all adults, are eligible for statin therapy or are already taking a statin, according to US Centers for Disease Control and Prevention.

"We need to focus on improving the way doctors identify patients who need a statin and how they present information to patients to make sure no one misses it." opportunity to improve one's heart health, "said Dr. Corey Bradley, lead author of the study and researcher at the Duke Clinical Research Institute in Durham, North Carolina, in a statement.

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Among people who were offered a statin but refused, the most common reason was fear of side effects.

"While there are risks associated with statins, the public's fear of side-effects is disproportionate to the actual risks," said Dr. Ann Marie Navar, lead author of the statins. study and assistant professor of medicine at the Duke Clinical Research Institute statement. "The misconceptions about statins are ubiquitous and are fed by false information on the Internet."

It's important to weigh the risks and benefits of a lifetime drug, such as statins, said Dr. Amit Khera, director of the Preventive Cardiology Program at UT Southwestern Medical Center, who did not participate at the study.

When Khera advises his own patients on statins, the three most frequently reported side effects are muscle pain, changes in cognitive function, and liver function.

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"Statins can cause muscle pain, but even if it's one in ten, it means that 9 out of 10 will not, and the vast majority will not, and that usually disappears when we stop statin, "said Khera.

Regarding concerns about cognitive decline, "This is not something that we see in large studies, so if that happens, it is rare and difficult to separate from cognitive decline." aging, "he said.

In addition, "we have realized over time that minor increases in liver function tests are not clinically significant, as statins very rarely cause severe liver injury in patients," he said.

The authors acknowledge that the new study had several limitations. Because it included patients who were part of a national registry and who were potentially eligible for statin therapy, they think the results might underestimate the number of people who go without receiving statins. .

The team recognizes that the results of a sample study are subject to recall bias, which means that patients who eventually started taking a statin were more likely to remember that this one was theirs. had been offered.

"It is possible that some people have not remembered giving us a statin, so we may have overestimated the percentage of people who have never received a statin, but we think that if the patient does not did not remember the conversation, the discussion would probably not have been effective, "Bradley said.

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