Antihyperlipidemic Use among Adults Aged 40 Years and More with Type 2 Diabetes - Assessment of Racial Disparities

OBJECTIVE: To evaluate antihyperlipidemic agent use among non-Hispanic white, black, and Hispanic and Asian adults with type 2 diabetes in the United States who quality for primary or secondary prevention of cardiovascular disease.METHODS: This is a retrospective cohort study that uses the cross-sectional National Health and Nutrition Examination Survey cohorts 2011-2016. Adults 40 year of age or older with type 2 diabetes self-described as non-Hispanic white, black, and Hispanic and Asian were included in this study. This is a population who is at higher risk of cardiovascular disease. Study outcome was defined as use of any antihyperlipidemic agent approved in the United States and was compared across racial/ethnic groups. All racial/ethnic minority groups including Hispanic and Asians have been over-sampled in this survey and all analyses have been adjusted for complex sample design. Socio-demographic parameters and additional cardiovascular risk factors were also collected and compared across racial/ethnic groups. Chi-squared and 1-way ANOVA were used to compare categorical (outcome and predictors) and continuous (predictors) across racial/ethnic groups. All estimates are nationally representative. An alpha of 5% was used. RESULT: 1830 participants were included and represent 18 million individuals nationally. The overall use of antihyperlipidemic agents was 41%. Differences in antihyperlipidemic agent use were observed across racial/ethnic groups: white (49.8%), black (38.6%), Hispanic (34.6%) and Asian (44.7%) and were statistically significant (p<0.05). Statistical differences of cardiovascular risk factors were observed across study groups and Asians we found to have more favorable risk factor trends than other study groups. CONCLUSION: This is the first national study to report antihyperlipidemic agent use in Asians and to evaluate their cardiovascular risk compared to other racial/ethnic groups. Overall, use of agents was low in a population that continues to have a high risk of cardiovascular disease.