OBJECTIVES: Dyslipidemia is a risk factor for coronary heart disease (CHD), which remains a leading cause of U.S. mortality, irrespective of sex, race/ethnicity, or age. Because the benefits of antilipidemics extend across patient characteristics, antilipidemic initiation rates should not widely vary by patient demographics. We conducted a large-scale retrospective claims analysis to confirm this assumption among newly-diagnosed adult dyslipidemic patients. METHODS: Nine-year (1997-2006) retrospective claims analysis of Florida Medicaid adults (³18 years) who had ³1 year of data before and ³3 years of data following their first dyslipidemia (ICD-9 272.X) diagnosis. Charlson Index classified disease burden. Logistic regression examined odds ratios. RESULTS: Among 231,110 dyslipidemic patients, 19,128 meeting eligibility criteria received antilipidemics during the index period; 18,346 did not. Women were 8% less likely to receive antilipidemics (OR 0.92, 95% CI 0.88-0.96, p=0.0005) than men. Treatment initiation rates among Hispanics did not significantly differ from Whites. Blacks were 23% less likely (OR 0.77, 95% CI 0.73-0.81, p<0.0001), and Other Ethnicities/Races 17% more likely (OR 1.17, 95% CI 1.11-1.24, p<0.0001) to receive antilipidemics during the follow-up period than Whites. Patients aged 50-64 years were 17% more likely (OR 1.17, 95% CI 1.10-1.25, p<0.0001), and those aged 18-49 years were 57% less likely (OR 0.43 95% CI 0.41-0.46, p<0.0001), to receive antilipidemics than patients ³65 years old. Patients with substantial disease burden (Charlson Index >1) were 9% more likely to receive antilipidemics (OR 1.09, 95% CI 1.01-1.18, p=0.024) than those with no or moderate disease burden (Charlson =1). CONCLUSION: Although CHD remains a leading cause of U.S.mortality irrespective of sex, race/ethnicity, or age, and antilipidemics benefit patients across these demographic characteristics, we found that females, Blacks, and younger (aged 18-50 years) Medicaid patients with dyslipidemia were significantly less likely to receive antilipidemics than their male, White or older counterparts.