Age-based disparities in statin use for primary prevention in US adults: National Health and Nutrition Examination Surveys 2013–2020.

• Among adults 40–75 years of age eligible for statins for primary prevention based on 10-year risk, rates of statin utilization by age are unknown. • Statin use for primary prevention is lower among US adults <65 vs. 65–75 years of age, despite similar predicted 10-year ASCVD risk and a higher burden risk factors. • Adults <65 years are treated less aggressively with statin therapy, leaving this population exposed to greater risk for future ASCVD events. Statin use among younger adults at high atherosclerotic cardiovascular disease (ASCVD) risk compared with older adults at the same risk is unclear. We determined prevalent statin use by 10-year ASCVD risk and age among US participants aged 40–75 eligible for risk-indicated primary prevention statins from the 2013–2020 National Health and Nutrition Examination Survey cycles. Among 3,503 participants, statin use by ASCVD risk (5-<7.5%, 7.5-<20%, and ≥20%) was 9.4%, 9.0%, and 12.2% among those age 40–54 compared to 22.0%, 23.9%, and 14.3% among adults 55–64 years and 39.3%, 33.6%, and 38.1% age 65–75 years. After adjusting for sociodemographic and healthcare access, the prevalence ratio (vs. 65–75 years) for statin use among adults with an ASCVD risk of 7.5-<20% age 40–54 years was 0.40 (95% confidence interval [CI] 0.39,0.41) and 0.87 (95% CI 0.87,0.88) for adults 55–64 years. Among high ASCVD-risk adults aged 40–75 years, primary prevention statin use was lower among adults <65 years despite similar ASCVD risk as older adults. [ABSTRACT FROM AUTHOR]