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Racial Disparities Exist in Use of Statins to Reduce Heart Disease Risk, UTSW Study Shows

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05/10/2023
utsouthwestern.edu

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DALLAS – May 09, 2023 – Black and Hispanic adults at risk of developing cardiovascular disease are less likely to take statin drugs than white adults with the same risk factors, UT Southwestern Medical Center researchers reported in JAMA Cardiology.

Age, sex, blood pressure, cholesterol, diabetes, and smoking status all increase a person’s likelihood for cardiovascular disease. Researchers found that even after adjusting for these risk factors, data showed that 37.6% of white participants used statins compared with 23.9% of Hispanic participants and 23.8% of Black participants. The study also showed that having health insurance and regular access to routine health care were associated with higher statin use.

Ambarish Pandey, M.D., Assistant Professor of Internal Medicine in the Division of Cardiology at UT Southwestern, is an expert on disparities in cardiovascular disease.

“This adds to the known racial and ethnic disparities already highly prevalent in heart disease,” said Ambarish Pandey, M.D., Assistant Professor of Internal Medicine in the Division of Cardiology at UT Southwestern, who is an expert on disparities in cardiovascular disease and the lead author of the study. “These findings have the potential to affect how we screen for and treat people who do not have heart disease but may have risk factors such as high blood pressure, high cholesterol, and smoking.”

Statins, which include atorvastatin (Lipitor) and simvastatin (Zocor), are among the most prescribed drugs in the U.S. In 1985, UT Southwestern researchers Michael S. Brown, M.D., and Joseph L. Goldstein, M.D., were awarded the Nobel Prize in Physiology or Medicine for their discovery of the LDL receptor and its role in cholesterol metabolism, which led to the drug’s development. 

Previous research has established that rates of cardiovascular disease – as well as many individual risk factors – are higher among Black and Hispanic adults than white adults. Due to those disparities, race and ethnicity are factors in a person’s individual risk of developing heart disease.

Previous studies have found lower statin use among Black and Hispanic adults who already have established heart disease or diabetes. The new study is the first to look at statin use across races and ethnicities in people with a broad range of risk factors.

Dr. Pandey and collaborators at the University of Utah analyzed data on a select group of people who completed the National Health and Nutrition Examination Survey (NHANES) between January 2013 and March 2020. The subset of participant records selected for the analysis was designed to represent the U.S. population. Dr. Pandey said the disparities found in statin use across race groups were independent of risk factors, including age, sex, and LDL cholesterol levels.

“The rates of statin use in those at the highest risk for cardiovascular disease is quite low overall, but especially among Black and Hispanic adults. Statins are cheap and effective at the prevention of heart disease, so this is definitely a large missed opportunity,” said Joshua A. Jacobs, Pharm.D., Cardiology Clinical Pharmacist at the University of Utah who is the first author of the study.

The new results, Dr. Pandey added, “help identify health care access as a target for interventions in order to shrink the racial and ethnic gap for preventive cardiovascular care.”

The next step would be to study the effectiveness of different interventions in increasing statin use among minority communities. “This way we can find strategies that work for the communities most affected by the disparity,” he said.

UTSW researcher Ann Marie Navar, M.D., Ph.D., contributed to the study.

Dr. Brown, a Regental Professor, holds The W.A. (Monty) Moncrief Distinguished Chair in Cholesterol and Arteriosclerosis Research, and the Paul J. Thomas Chair in Medicine. Dr. Goldstein, a Regental Professor, holds the Julie and Louis A. Beecherl, Jr. Distinguished Chair in Biomedical Research, and the Paul J. Thomas Chair in Medicine.

Information on author financial disclosures can be found in the manuscript.

About UT Southwestern Medical Center  

UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 26 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.

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