• K D Valentine, Suzanne Brodney, Karen Sepucha, and Michael J Barry.
• Health Decision Sciences Center, Massachusetts General Hospital, Boston, USA.
• J Gen Intern Med. 2023 Jan 1; 38 (1): 364136-41.

BackgroundGuidelines suggest clinicians inform patients about their 10-year cardiovascular disease (CVD) risk; however, little is known about how the risk estimate influences patients' preferences for statin therapy for primary prevention.ObjectiveTo define predictors of preference for statin therapy after participants were informed about their individualized benefits and harms.DesignCross-sectional survey in 2020.SettingOnline US survey panel.ParticipantsA national sample of 304 respondents aged 40 to 75 who had not previously taken a statin and who knew their cholesterol levels and blood pressure measurements.InterventionParticipants entered their risk factors into a calculator which estimated their 10-year CVD risk. They were then provided with an estimate of their absolute risk reduction with a statin and the chance of side effects from meta-analyses.Main MeasurementsWe used a hierarchical model to predict participants' preferences for statin therapy according to their 10-year CVD risk, perceptions of the magnitude of statin benefit (large, medium, small, or almost no benefit), worry about side effects (very worried, somewhat worried, a little worried, not worried at all), and other variables.Key ResultsParticipants had a mean age of 55 years (SD = 9.9); 50% were female, 44% were non-white, and 16% had a high school degree or less education. After reviewing their benefits and side effects, 45% of the participants reported they probably or definitely wanted to take a statin. In the full hierarchical model, only perceived benefits of taking a statin was a significant independent predictor of wanting a statin (OR 7.3, 95% CI 4.7, 12.2).LimitationsParticipants were from an internet survey panel and making hypothetical decisions.ConclusionsParticipants' perceptions of their benefit from statin therapy predicted wanting to take a statin for primary prevention; neither estimated CVD risk nor worries about statin side effects were independent predictors.© 2022. The Author(s) under exclusive licence to Society of General Internal Medicine.

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