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According to a study, doctors fail statins for more than half of eligible patients



Researchers surveyed 5,693 individuals from the patient and supplier assessment of the Lipid Management Registry, a national database of medical practices in the United States. A total of 1,511 of the adults were not treated with a statin, although they met the criteria for the medication according to the guidelines of the American College of Cardiology of 2013 and the American Heart Association (American Heart Association).

A majority – 59% – of the 1,511 quoted the fact that their doctor had never offered the drug. Ten percent said they needed to lose statins after their doctor recommended them, and 30.7 percent had taken a statin, but decided to end the study, which was published Wednesday in the Journal of the American Heart Association.

Those who claim they were never offered a statin were women, African Americans, and uninsured, according to the study.

Statins work by lowering the amount of "bad" cholesterol called low density lipoprotein or LDL. Because the drugs may reduce the risk of heart attacks and strokes, the American Heart Association and the American College of Cardiology recommend that doctors use a 1
0-year risk calculator to determine which patients can benefit from such therapy.
According to the United States Centers for Disease Control and Prevention, more than 78 million Americans, or just over a third of adults, are taking statin therapy or are already taking a statin.

"We need to focus on improving the way physicians identify patients who need a statin, and how they share information with patients to ensure that no one misses the opportunity to improve heart health," said Dr. Corey Bradley, lead author of the study and researcher at the Duke Clinical Research Institute in Durham, North Carolina, in a statement.

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Among those who were offered a statin but reduced it, the most common cause was the fear of side effects.

"Although there are risks associated with statins, the public's fear of side effects is out of proportion to the actual risks," Dr. Ann Marie Navar, lead author of the study and assistant professor of medicine at the Duke Clinical Research Institute, in a statement. "Errors about statins are everywhere and are fueled by false information on the internet."

It's important to weigh the risks and benefits of a lifelong drug, such as statins. Amit Khera, Director of the Preventive Cardiology Program of UT Southwestern Medical Center, who was not involved in the study.

When Khera asks his own patients about statins, the three side effects they are most frequently asked for are muscle aches, changes in cognitive function, and liver function.

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"Statins can cause muscle aches, however even if it's as high as one in ten who gets muscle pain, it means it will not, and for the vast majority it will not, and it generally goes away when we stop the statin, "Khera said.

Concerning cognitive decline concerns, "is not seen in large scale studies, and if so, it is rare and difficult to separate from the usual cognitive decline of aging," he said.

In addition, "over time we have found that slight elevations in liver function tests are not clinically significant because statins are very important in causing rare liver damage to patients," he said.

The authors acknowledge that the new study had some limitations. Because patients were included who were part of a national registry and who may have been eligible for statin therapy, they believe the results may underestimate the number of people who do not use statins.

In a survey study, the team acknowledges that the results are biased, which means that patients who eventually start taking a statin are more likely to remember that they were offered to them.

"It is possible that some people did not remember being offered a statin, so we may have overestimated the percentage that was never offered, but we believe the discussion is likely to be, if The patient did not remember the conversation was not effective, "said Bradley.


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