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Statin therapy is a primary strategy for secondary prevention of cardiovascular disease (CVD). Clinical trials demonstrate that high-intensity statin levels are more effective than lower levels in reducing mortality rates. Despite treatment guidelines, statin therapy may be underutilized. Our primary objective was to determine the prevalence of statin utilization, by varying intensity in secondary CVD prevention. A random sample of older adults in AARP® Medicare Supplement plans insured through UnitedHealthcare was utilized to identify those with established CVD. Five categories of statin utilization were established: compliant with high, moderate or low-intensity therapy, non-compliant, and statin non-user. Among eligible insureds, 16% were high-intensity users. Women were less likely to be high-intensity statin users and more likely to be non-users compared to men. Mortality rates significantly increased in a dose-related pattern as statin therapy intensity decreased. Likewise, adjusted hazard ratios indicated the most benefit from high-intensity statin therapy compared to all other categories. The benefits of high-intensity statin therapy for men and women were similar. Statin therapy for secondary CVD prevention is underutilized with only 16% of the overall study population receiving high-intensity therapy. Women were less likely to receive statins at any level compared to men. About one-quarter of the population were non-compliant, thus health literacy interventions may be appropriate. Meanwhile, awareness among physicians of recommended treatment guidelines should be encouraged.