Journal of Lipid and Atherosclerosis · Aug 8, 2025

Prevalence of Statin Intolerance in a Primary Care Portuguese Population: A Retrospective Cohort Study

By Gavina C, Araújo F, Luz AR et al.

OBJECTIVE: We estimated the prevalence of statin intolerance (SI) in a Portuguese primary care population, applying the CLEAR Outcomes trial inclusion criteria. METHODS: This retrospective study analyzed electronic health records (EHRs) from the Local Health Unit of Matosinhos, Portugal (from system launch through December 2023). The study included both men and women (postmenopausal, surgically sterile, or using birth control) aged 18-85 years, with a history of atherosclerotic cardiovascular disease (ASCVD) or at high/very-high ASCVD risk, and a low-density lipoprotein cholesterol (LDL-C) level ≥100 mg/dL while receiving lipid-lowering therapies. The index date was defined as the date when each patient met all eligibility criteria. SI (the prescription of ≥2 statins at any dose, or 1 statin at any dose in patients unwilling to try a second statin) was identified through free-text search. Univariate logistic regression analyses were performed. RESULTS: In total, 12,393 patients were eligible for inclusion. SI was observed in 9.6% (n=1,195) of patients, who in December 2023 had a median (1st to 3rd quartiles) age of 73 years (68-78 years) and a median LDL-C of 100 mg/dL (76-129 mg/dL). Most patients were male (55.2%), had ≥3 comorbidities (78.2%), and 42.1% were prescribed a moderate-intensity statin. Individuals aged ≥70 years had a higher likelihood of SI (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.1-1.4). Women showed a non-significantly higher likelihood of SI (OR, 1.1; 95% CI, 0.9-1.2). CONCLUSION: The prevalence of SI observed in this study is consistent with existing literature and is particularly elevated in older individuals. These findings highlight the need to prioritize alternative therapies for dyslipidemia in this population.

doi.org/10.12997/jla.2026.15.1.138 Open access PubMed 41660519 Interventions