Heart Disease In The News

Doctors rate poorly in their use of statins
January 9, 2001      

According to a study in this week's Archives of Internal Medicine, doctors are not correctly following cholesterol-treatment guidelines (The National Cholesterol Education Program expert panel guidelines, called the Adult Treatment Panel II guidelines).

The study was conducted as a medical records review in a major U.S. hospital.  Records were studied for compliance with guidelines in all patients receiving statins, and for all patients with coronary artery disease (many of whom should be taking statins.

The investigators discovered that among patients taking statins, the overuse of statins (according to the guidelines) was between 47% and 69%.  For patients with coronary artery disease not taking statins, 88% were undertreated. 

Thus, it appears that even in very sophisticated medical centers, the use of statin drugs among physicians is inappropriate compared to guidelines (either overuse or underuse,) much of the time. 

We should note that the so-called overuse of statins is somewhat controversial, as data has been accumulating that statins may be useful in several ways not yet reflected in the formal  guidelines.  But there seems to be little excuse for the underuse of statins in patients with coronary artery disease, a patient population in which the use of these drugs has been well-documented to reduce mortality.  Any patient with coronary artery disease who is not on statins should specifically question his/her doctor about their adherence to the National Cholesterol Education Program guidelines.

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