Use of Antihyperlipidemics among Adults with Cardiovascular Disease in the US and England from 2003-2012

Antihyperlipidemics are proven effective for the secondary prevention of cardiovascular disease (CVD). Comparative analysis on the prevalence of antihyperlipidemic use for secondary prevention of CVD has not been completed between the US and England. Prevalence of antihyperlipidemic use was estimated using the National Health and Nutri- tion Examination Survey (2003-2004, 2005-2006, 2011-2012) and the Health Survey of England (2003, 2006, 2011). Analyses were restricted to participants over 40-years old with CVD. Over 70% of English respondents with CVD use antihyperlipidemics (73.2%), compared to 62.3% of American respondents (11.0pp difference, p=0.10). Low-income Americans report lower prevalence of antihyperlipidemic use than their English counterparts, 51.8% and 76.5% respectively (24.7pp difference, p<0.01). American respondents have reduced odds of using an- tihyperlipidemics compared to the English (OR 0.73; p<0.01). This association persisted after accounting for sociodemographic/economic and CVD risk factors. After accounting for health status the association between country of residence was attenuated. In models restricted to in- dividual country, lower socioeconomic status was associated with significantly reduced odds of using antihyperlipidemics in the US but not in England. Differences in the use of antihyperlipidemics exist between and within the US and Eng- land. Universal health insurance may explain the greater, more equitable use of antihyper- lipidemics among respondents with CVD in England compared to the US.