Nearly 77% of Bangladeshis with Heart Disease History Not Using Statins

Nearly 77% of Bangladeshis aged 40 to 69 with a history of cardiovascular disease were not using statins, medicines that can reduce harmful cholesterol and lower the risk of recurrent heart attacks and strokes, according to a study highlighted ahead of World Heart Day on September 29.

The findings were published in the global scientific journal Global Heart in March last year. The study, titled “Burden and Predictors of Statin Use for Primary and Secondary Prevention of Cardiovascular Disease in Bangladesh: Evidence from a Nationally Representative Survey”, was conducted by researchers from the National Heart Foundation Hospital and Research Institute of Bangladesh.

Researchers analysed data from 3,140 participants in the 2018 World Health Organization (WHO) STEPS Bangladesh survey. Of them, 443 had previously suffered from cardiovascular disease, but only 23.5% were using statins.

Statins are medicines that lower low-density lipoprotein, or “bad”, cholesterol in the blood. High LDL cholesterol can cause fat and other substances to build up in artery walls, forming plaques that narrow blood vessels or rupture and cause blood clots. Such blockages can lead to heart attacks or strokes.

Statins are also used for secondary prevention among people who have already experienced cardiovascular disease, including patients who have undergone stent placement or bypass surgery. Many patients need to continue taking statins for long periods, and some may require them for life.

The study also found a gap in statin use for primary prevention. Under WHO’s 2019 guidelines, 11.2% of participants without cardiovascular disease should have been using statins for primary prevention, but only 6.9% were taking the medicines.

Professor Sohel Reza Choudhury, one of the researchers and head of the Department of Epidemiology and Research at the National Heart Foundation of Bangladesh Hospital, said statins are not prescribed only for people with high cholesterol.

“Statins are also given to people at high risk of heart disease,” Professor Choudhury told Ajker Patrika. “For primary prevention, there are recommendations to prescribe statins after considering specific risks for people who have not yet developed heart disease but face high risks, such as diabetes or hypertension patients aged over 40, or smokers.”

“Statins are also important after heart disease develops. This is secondary prevention. Statins are prescribed to prevent another heart attack or other cardiovascular problem after someone has already had heart disease,” he said. “But our analysis found that fewer than 25% of those who should take these medicines were regularly using statins.”

Professor Choudhury said the research used nationally representative data from the 2018 STEPS survey, but cautioned that the 23.5% figure should not be treated as the current nationwide statin-use rate among all heart disease patients because the analysis focused on a smaller subgroup with a history of cardiovascular disease.

WHO STEPS Bangladesh is a national health survey designed to assess non-communicable diseases and their risk factors, including tobacco use, diet, physical measurements, blood pressure, blood cholesterol and blood sugar.

Deaths from non-communicable diseases such as heart disease and diabetes are increasing in Bangladesh. WHO’s latest country-level data showed that the death rate from ischaemic heart disease in Bangladesh was 58.5 per 100,000 people in 2021, while the stroke death rate was 80.2 per 100,000.

A study published in the UK-based journal BMJ Public Health in April 2026 found that around 10.3% of Bangladeshis aged 40 to 69 faced at least a 10% risk of developing cardiovascular disease within the next 10 years. The figure was 9.2% when risk was calculated without blood-test data.

The study analysed data from 2,782 people in the 2018 national survey on non-communicable disease risk factors. Men and people with abdominal obesity and high levels of harmful cholesterol faced higher risks, Professor Choudhury said.

Cardiovascular disease includes heart attacks, other heart conditions, strokes and diseases affecting blood vessels in the arms and legs.

Experts also called for a national cardiovascular disease registry, saying the absence of such a system prevents an accurate assessment of disease trends. Much of the available information is hospital-based, while comprehensive data on community-level illness and deaths are unavailable.

Professor Mohammad Safiuddin, convener of the Bangladesh Cardiac Society, said emergency cardiac care should not remain concentrated in major cities or private hospitals.

“Emergency cardiac treatment must be made accessible at district and upazila levels through the public system,” Professor Safiuddin said. “At the same time, a reliable national heart disease registry must be established in the country.”

Bangladesh has expanded its capacity for heart disease treatment, but services remain insufficient compared with patient demand. Many hospitals require patients to wait three to four months for bypass surgery.