CMHC Pulse Blog

“One of the reasons for statin underutilization is that patients frequently go on the internet and read the negative complications associated with statins and are afraid to take a statin therapy. Another reason is that hypercholesterolemia is a silent killer. One does not feel anything until something bad happens like a heart attach or a stroke, and it is always very hard to treat silent conditions. That is why, for example, blood pressure is hard to treat, and we still do a dismal job in controlling it” — Leslie Cho, MD, Professor of Medicine and Section Head of Preventative Cardiology and Rehabilitation at the Cleveland Clinic in Ohio – told Cardiometabolic Chronicle in an interview.

The prevalence of statin intolerance is still widely debated mostly due to difficulties in identification and diagnosis.10 “Statin intolerance is unfortunately very common, but when we look at randomized controlled studies, reported rates are as low as <1% of the study populations. Part of this is due to randomized studies enrolling healthier patients; also, patients that had statin-related adverse events during the run-in-period were excluded from the studies. Conversely, when we look at real-world registries, such as the French registry of primary care clinics11 or US insurance database studies2, statin intolerance is around 5-10%” – Dr. Cho added.


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