A new study finds only about 1/3 of people who could benefit from statin medications — which can help prevent heart attacks and strokes among people at risk — are taking them.

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Statin medications are extremely effective in lowering cholesterol and preventing heart attacks. But a study published in the Annals of Internal Medicine finds that only about one-third of people eligible to take them actually do. NPR's Allison Aubrey reports.

ALLISON AUBREY, BYLINE: The FDA approved the first commercial statin medication back in the late 1980s. And since that time, there's been a lot of evidence that the medications can significantly reduce the risk of having a heart attack or a stroke, says primary care doctor Tim Anderson of the University of Pittsburgh.

TIM ANDERSON: Generally, statins, when taken regularly, will drop cholesterol levels 30- to 40%. Statins are the most effective tool in our toolkit to try to help folks reduce that chance of a heart attack or a stroke down the road.

AUBREY: Yet millions of people who could benefit don't use them, and Anderson wanted to nail this down. So he and his collaborators analyzed data from the National Health and Nutrition Examination Survey. They found that, over the last 10 years, the use of statins, even for primary prevention - meaning among those who've not yet had a heart attack or stroke but are at high risk - has trailed off. Only about 35% of people who are eligible use them, even as generic versions have lowered the cost of the medicines.

ANDERSON: What's surprising here is that it's fully leveled off, and that has even happened as statins have become more affordable. And so that leveling off is quite surprising.

AUBREY: There are a bunch of reasons why people who are eligible may not take statins. Some are not aware they could benefit. In primary care visits, providers can calculate a patient's 10-year risk of having a cardiovascular event, which is one measure used to determine who's a good candidate to be on a statin.

ANDERSON: As we age, most, if not all, folks' cholesterol slowly rises, even with a healthy lifestyle. And so one of the reasons we talk about cholesterol in folks in their 40s, 50s and 60s is really that, even with healthy lifestyle, we know cholesterol levels and that risk could creep up.

AUBREY: Some people hesitate to take a statin due to concerns about side effects. But Anderson says doses can be adjusted to minimize this, and most people tolerate the medications. Other people turn to lifestyle changes in lieu of medicines.

ANDERSON: For some patients, we can reduce cholesterol through things like changing diet and regular exercise. But for many folks, even when following those heart-healthiest diets, cholesterol often still runs in families, and there's a genetic component to that.

AUBREY: So it may be hard to bring down levels enough. Anderson says understanding the risks and benefits of statins is something people can ask their providers about before their risk creeps up.

Allison Aubrey, NPR News.

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