Key result
Statin use reaches only ~3% among primary care adults with cardiovascular risk enhancers.
Why the study?
There is scarce evidence on real-world statins use in primary care settings in low-middle-income countries.
Cross-Sectional (n=415,766)
Yes
There is a very low prevalence of statin use (2.6%) for primary prevention among adults with cardiovascular risk enhancers in primary care in Brazil, highlighting a significant gap in guideline implementation.
Answers are grounded in this paper and cite their sources.
Low statin uptake in high-risk Brazilian primary prevention; leaves open whether digital tools or targeted policies can close gaps in LMIC settings.
BACKGROUND: Statins are the main strategy to reduce dyslipidemia-related cardiovascular risk. Nevertheless, there is scarce evidence on the real-world statins use in primary care settings in low-middle-income countries. OBJECTIVE: We conducted a cross-sectional retrospective study using anonymized data routinely collected by community health workers in Brazil aimed to evaluate statin use and associated factors in a primary prevention population with cardiovascular risk enhancers. METHODS: Study population consisted of adults with hypertension, diabetes, and/or dyslipidemia. The primary and secondary outcomes were the proportion of individuals self-reporting statins use on any dose and high-dose statins/high-intensity lipid-lowering therapy (LLT), respectively. RESULTS: Of the 2,133,900 adult individuals in the database, 415,766 (19.5%) were included in the study cohort. From this cohort, 89.1% had hypertension, 28.9% diabetes, and 5.5% dyslipidemia. The mean age was 61.5 (standard deviation 14.5) years, 63.4% were female, and 61.0% were of mixed-race. Only 2.6% and 0.1% of individuals self-reported the use of statins and high-dose statins/high-intensity LLT, respectively. Older age (odds ratio [OR] 1.96; 95% confidence interval [CI] 1.88, 2.05, p < 0.001), living in the South region of Brazil (OR 4.39; 95% CI 3.97, 4.85, p < 0.001), heart failure (OR 2.60; 95% CI 2.33, 2.89, p < 0.001), chronic kidney disease (OR 1.49; 95% CI 1.35, 1.64, p < 0.001), and anti-hypertensive medications use (OR 4.38; 95% CI 4.07, 4.71, p < 0.001) were independently associated with statin use. CONCLUSION: In a real-world evidence study analyzing data routinely collected in a digitized primary care setting, we observed a very low use of statins in a primary prevention population with cardiovascular risk enhancers in Brazil. Socio-demographic factors and co-morbidities were associated with higher statins use rates.
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Santo et al. (2024) conducted a cross-sectional in Cardiovascular risk enhancers (hypertension, diabetes, and/or dyslipidemia) (n=415,766). Statin use was evaluated on Proportion of individuals self-reporting statins use on any dose. In a Brazilian primary care cohort of 415,766 adults with cardiovascular risk enhancers, only 2.6% self-reported statin use, with older age and comorbidities associated with higher use.
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