National Trends in Statin Use by Coronary Heart Disease Risk Category

This national survey study tracked statin prescribing patterns from 1992 to 2002, charting the rapid rise of statin therapy and identifying which guideline-eligible patients were still not receiving treatment.

Statin use grew dramatically — from 4 percent to 19 percent among high-risk patients over a decade — with atorvastatin capturing the majority of statin prescriptions by 2002. Despite this growth, more than half of moderate- and high-risk patients with hyperlipidemia were not on statin therapy at the study’s end. Persistent disparities by race, sex, and age were documented throughout: Black patients, women, and younger adults received statins less frequently than their risk profiles warranted.

The study reflects a historical moment before the 2004 NCEP ATP III update and the “lower is better” trials (PROVE-IT, TNT) further accelerated statin intensification. Its primary value today is documenting the substantial lag between evidence availability and clinical practice translation — and the systematic disparities in who benefited from therapeutic advances during this period.

We rate the evidence moderate. Informative health services data on statin adoption and treatment inequities; the clinical message is about implementation gaps and disparities rather than efficacy of the treatments themselves.