Statin Drugs in the United States

The use of statin drugs increased dramatically from 1990 to 2010 before the growth rate slowed. Doctors prescribe statins because oftheir effectiveness in lowering LDL cholesterol, their ability to decrease the rate of death from heart attacks or stroke, and their reputation as "safe drugs" with few and tolerable side-effects.

It is thought that 32 million people in the US take statins and up to 200 million people worldwide. In 2018 the website Phys.org wrote "statins are the most widely prescribed drug in the world, According to the journal the BMI, “statins are the UK’s most commonly prescribed drugs." In the US, over 70 percent percent of adults with heart disease were taking a cholesterol-lowering drug as of 2013, according to the CDC. The American Heart Association says one in four Americans past age 40 takes a statin.

According to the National Health and Nutrition Examination Survey 17% of US residents between the ages of 40 and 59 take a statin, The number is 43% of those in 60 to 79 year of age and 48% of those over 80.

Among Americans past age 40, 71% of those with cardiovascular disease take a statin, 63% of those with diabetes, and 54% of those with high cholesterol.

Giving statins to people who do not yet show symptoms of coronary artery disease is called chemoprophylaxis, or primary prevention, and is increasingly accepted as a form of care in individuals who are susceptible.

An article in The Lancet in 2012 looked at a meta-analysis (an analysis of other analyses) and concluded that the benefits so outweight the downsides that the guidelines for statin usage should be widened. If the Cholesterol Treatment Trialists (the group who authored the analysis) suggestions were to be implemented, more than half of all Americans past age 35 would be started on statins.

According to the Center for Disease Control and Prevention, heart disease has been the leading cause of death in the United States since 1921. High levels of LDL cholesterol can increase a patient's risk of heart disease, and may be resistant to changes in diet or exercise. While a low-fat, low-cholesterol diet and increased exercise are generally recommended, statin drugs are often needed in addition to these lifestyle changes in order to lower LDL cholesterol levels and reduce the risk of heart disease.

Much of the enormous growth of the pharmaceutical industry in the 80s, 90s, and 00s, can be traced to the introduction of drugs that treat chronic conditions. The drugs don't cure the condition, but they lessen its effects and improve life for the person taking them. Statins fit into this category. Once a person starts taking statins, he or she presumably takes them indefinitely or for the rest of life. The statins are also given prophylactically; indeed they are the first drugs to see widespread use to prevent development of disease and illness.

Statins, as a class of drugs, are among the most highly prescribed medications not only in the United States but also around the world in developed countries like Great Britain and Australia plus the European continent. As the medical profession continues to advocate lower serum cholesterol levels for adults of all ages, more people are taking statins as prevention against heart disease.

Overuse?

A University of Michigan study released in 2013 suggested doctors too often prescribe statins to patients who are not likely to benefit from them. An expert told the media it was more evidence of how "physicians are trigger happy" and give the drugs willy nilly.

An article in the Saturday Evening Post claims that studies have shown that in otherwise healthy people with no history of cardiovascular problems, statins provide no reduction in mortality risk. The article lauds use of statins as “one of the greatest public health triumphs of the past 30 years” but casts serious doubt on use for primary prevention, noting that studies have found a rather insignificant reduction in risk. The bang-for-the-buck from statins is small for low-risk individuals, and although the costs (monetary and side effects) are small, they may outweigh the benefits.