Statin Eligibility and Prescribing Across Racial, Ethnic, and Language Groups over the 2013 ACC/AHA Guideline Change: a Retrospective Cohort Analysis from 2009 to 2018

Heintzman, John; Kaufmann, Jorge; Rodríguez, Carlos J.; Lucas, Jennifer; Boston, Dave; April-Sanders, Ayana; Chung-Bridges, Katherine

doi:10.1007/s11606-023-08139-x

Cited by 2 publications

(2 citation statements)

References 54 publications

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“…For example, a large retrospective analysis examined rates of statin eligibility and prescriptions across racial, ethnic, and language groups. 27 After adjusting for gender, age, income status, insurance status, hypertension, hyperlipidemia, obesity, primary care utilization, and Medicaid expansion status Asian, Black, Latino and non-English speaking White patients were more likely to be statin eligible than English speaking White patients. Of these, all but English-speaking Black and Latino patients were more likely to be prescribed statins than Englishspeaking White patients.…”

Section: Statin Eligibilitymentioning

confidence: 99%

“…[24][25][26] This may be in part due to the 2013 ACC/AHA guidelines expanding statin eligibility by recommending the use of the PCE, rather than just LDL-C levels to determine statin eligibility. 27,28 This expansion has been shown to appropriately identify at risk individuals but has also been shown to overestimate ASCVD risk in certain populations. [29][30][31][32][33]…”

Section: Preventative Medication Usementioning

confidence: 99%

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Clinical characteristics and statin eligibility of patients under 50 with ST‐elevation myocardial infarction

Haq,

Walser‐Kuntz,

Gamam

et al. 2024

Clinical Cardiology

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AimsThis study seeks to understand the clinical characteristics, risk factors, and statin eligibility of younger adults who present with STEMI.MethodsWe performed a retrospective analysis of a prospective cohort of STEMI patients <50 years. Baseline characteristics, medical history, prior medications, drug use, lipid profiles, cardiovascular risk factors were examined. Ten‐year ASCVD risk was calculated utilizing the Pooled Cohort Equations. Statin eligibility was determined according to the 2019 American College of Cardiology (ACC)/American Heart Association (AHA) and the 2022 US Preventive Services Task Force (USPSTF) guidelines.ResultsSix hundred and thirty‐five individuals were included, the majority were men (82.4%) and white (89%), with a median age was 46.9 [42.0–48.0]. The most prevalent risk factors were current smoking (59%), hyperlipidemia (44%), and hypertension (37%). Drug use was rare (8.3%). Preventative medication use was low, aspirin was the most common (14%), followed by ACE inhibitors/ARBs (12%), statins (11%), and beta‐blockers (9.1%). Mean HDL‐C was low at 36.4 ± 12.0 mg/dL, while mean LDL was unremarkable at 112.4 ± 37.9 mg/dL. According to the 2019 ACC/AHA guidelines, 45.5% were classified as statin recommended, 8.7% were classified as statin considered, and 45.8% were classified as statin not recommended. According to the 2022 USPSTF guidelines, 29% were classified as statin recommended, 12.4% were classified as statin considered, and 58.6% were classified as statin not recommended.ConclusionsYounger adults with STEMI exhibit high rates of tobacco use and low rates of preventative medications use. Approximately half of the cohort did not meet criteria for statin initiation.

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Section: Statin Eligibilitymentioning

confidence: 99%

Section: Preventative Medication Usementioning

confidence: 99%

Clinical characteristics and statin eligibility of patients under 50 with ST‐elevation myocardial infarction

Haq,

Walser‐Kuntz,

Gamam

et al. 2024

Clinical Cardiology

View full text Add to dashboard Cite

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Latino–White Disparities in Identification and Control of Elevated Blood Pressure Among Adults With Hypertension

Boston,

Hwang,

Lucas

et al. 2024

JAHA

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Background Studies analyzing blood pressure (BP) management using the hypertension control cascade have consistently shown disparities in hypertension awareness, treatment, and BP control between Latino patients and non‐Latino White patients. We analyze this cascade using electronic health record data from a multistate network of community health centers. Methods and Results Data from 790 clinics in 23 US states from 2012 to 2020, including 1 270 174 patients, were analyzed to compare BP documentation in the electronic health record, clinician acknowledgment (diagnosis or treatment) of incident hypertension (BP ≥140/90), medication prescription, and BP control between non‐Latino White patients, English‐preferring Latino patients, and Spanish‐preferring Latino patients, adjusted for patient‐level covariates, and clustered on patients' primary clinics. Among the 429 182 patients with elevated BP (≥140/90) during ambulatory visits from 2012 to 2020, we found that clinician acknowledgment of hypertension was more likely in Spanish‐preferring and English‐preferring Latino patients versus non‐Latino White patients (adjusted odds ratio [aOR], 1.17 [95% CI, 1.11–1.24]; aOR, 1.07 [95% CI, 1.02–1.12], respectively). In addition, Spanish‐preferring Latino patients were more likely to receive a medication versus non‐Latino White patients (aOR, 1.21 [95% CI, 1.16–1.28]). Among those receiving medication, Latino patients were as likely as non‐Latino White patients to have their BP controlled (<140/90). Conclusions In a large retrospective study of community health center patients with incident hypertension, the expected disparities in hypertension management between Spanish‐preferring Latino, English‐preferring Latino, and non‐Latino White patients were not identified. These findings add to the hypertension control cascade by examining robust electronic health record data from community health centers and may provide clues to reducing disparities in hypertension management.

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Statin Eligibility and Prescribing Across Racial, Ethnic, and Language Groups over the 2013 ACC/AHA Guideline Change: a Retrospective Cohort Analysis from 2009 to 2018

Cited by 2 publications

References 54 publications

Clinical characteristics and statin eligibility of patients under 50 with ST‐elevation myocardial infarction

Clinical characteristics and statin eligibility of patients under 50 with ST‐elevation myocardial infarction

Latino–White Disparities in Identification and Control of Elevated Blood Pressure Among Adults With Hypertension

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