Since high blood cholesterol is a major risk factor for coronary heart disease, the lipid-lowering drugs, known as statins, are a major part of reducing risk of heart disease for many patients. Some cardiologists even joke that statins should be put in municipal water, along with fluoride. Researchers looked at how many patients at risk of heart disease are prescribed statins.

What the researchers wanted to know: What are the trends in statin use for people at risk of coronary heart disease?

What they did: The researchers rounded up data from 1992 to 2002 collected for the National Center for Health Statistics, a part of the Centers for Disease Control and Prevention. The data came from two different surveys conducted to assess medical care—one on the healthcare physicians provide in their offices and the other on outpatient hospital care. For each patient visit reported, the researchers estimated the patient's coronary heart disease risk by counting risk factors, and classified them as low (zero to one risk factors), moderate (two or more risk factors), or high-risk—people with coronary heart disease, other diseases related to hardening of the arteries, or diabetes. They also looked at which patients were taking statins.

What they found: Not surprisingly, patients at high risk of coronary heart disease were the most likely to be taking statins. Rates of statin use went up from 1992 to 2000 but fell again after that: In 1992, high-risk patients reported that they were taking statins at only 14 percent of visits, while in 2000, they were using statins at 60 percent of visits. That rate fell to 50 percent in 2002. The rate in patients at moderate risk of coronary heart disease followed a similar pattern.

What the study means to you: The researchers say that, despite the increase in statin use over the past decade, the drugs still aren't being as widely prescribed as they should be. They say evidence suggests that many high-risk patients, for example people with diabetes, might be helped by statins even if their cholesterol isn't incredibly high. They also note that younger, female, and black high-risk patients are less likely to be on statins.

Caveats: These surveys focus on patient visits, not individual patients. So if a patient at high risk who's taking statins goes to see the doctor three times, he could be included three times in the survey, which would overestimate how often high-risk people are given statins. Also, like any drug, statins have risks.

Find out more: Read information about statins for patients, from the journal Circulation.

Read the article: Ma, Jun, et al. "National Trends in Statin Use by Coronary Heart Disease Risk Category." PLoS Medicine. May 2005, Vol. 2, No. 5, e123.

Article online: http://medicine.plosjournals.org