Treatment gaps and potential cardiovascular risk reduction from expanded statin use in the US and England

Background: The updated national guidelines for cardiovascular risk assessment and lipid modification in the UK and US expand the indications for statin therapy in primary prevention to adults with moderate risk of cardiovascular disease (CVD) but many adults at high CVD risk remain untreated in both countries. We set out to identify treatment gaps in English and American adults at moderate and high risk of cardiovascular disease (CVD), and to estimate the number of CVD events that would be prevented from expanding statin therapy to those who are currently untreated. Methods: We used nationally representative samples of 10,375 English adults and 7,687 US adults aged 40–75 years and free of existing CVD from the Health Survey for England 2009–2013, and the National Health and Nutrition Examination Survey 2007–2012 in the US. We used the risk algorithms and the risk thresholds for statin therapy recommended by each country’s national guideline to categorize the survey participants into moderate-risk (≥10% to <20% 10-year risk of CVD in England and ≥7.5% to