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Demographic Disparities in Guideline-Recommended Statin Use 

Among participants in the National Health and Nutrition Examination Survey for 2015–20, variations in guideline-recommended statin use among minoritized racial/ethnic groups and women “are not explained by measurable differences in medical appropriateness of therapy, access to health care, and socioeconomic status,” researchers report. “These residual disparities may be partially mediated by unobserved processes that contribute to health inequity, including bias, stereotyping, and mistrust.”

The cross-sectional analysis included people eligible for statin therapy based on American College of Cardiology/American Heart Association blood cholesterol guidelines from 2013 and 2018. Adjusted prevalence ratios (aPRs) were used to estimate disparities in statin use adjusted for age, disease severity, access to health care, and socioeconomic status relative to non-Hispanic White men.

“For primary prevention, we identified a lower prevalence of statin use that was not explained by measurable differences in disease severity or structural factors among non-Hispanic Black men (aPR, 0.73 [95% CI, 0.59 to 0.88]) and non-Mexican Hispanic women (aPR, 0.74 [CI, 0.53 to 0.95]),” the authors write. “For secondary prevention, we identified a lower prevalence of statin use that was not explained by measurable differences in disease severity or structural factors for non-Hispanic Black men (aPR, 0.81 [CI, 0.64 to 0.97]), other/multiracial men (aPR, 0.58 [CI, 0.20 to 0.97]), Mexican American women (aPR, 0.36 [CI, 0.10 to 0.61]), non-Mexican Hispanic women (aPR, 0.57 [CI, 0.33 to 0.82), non-Hispanic White women (aPR, 0.69 [CI, 0.56 to 0.83]), and non-Hispanic Black women (aPR, 0.75 [CI, 0.57 to 0.92]).”

Source: Annals of Internal Medicine