OBJECTIVE: The purpose of this research was to measure prevalent and incident statin use in the population of British Columbia from 1996 to 2004 across specific patient characteristics (sociodemographic and clinical). METHODS: Statin utilization and demographic data were assessed with the use of prescription drug claims. Medical and hospital claims for statin users were examined for evidence of ischemic heart disease (IHD), diabetes mellitus (DM), atherosclerosis, cerebrovascular disease, peripheral vascular disease (PVD), and disorders of lipid metabolism during the 3 years before the first statin prescription. RESULTS: Statin prevalence increased from 1996 to 2004 (1.28 %-6.59%). The greatest use was among those aged 65 to 84 years. Prevalent use of atorvastatin, simvastatin, and rosuvastatin increased over time. There were 211,964 new statin users between 1999 and 2004. Quarterly incident statin use increased over time from 1999 to 2004 (0.29%-0.49%). A socioeconomic gradient, whereby use was greater in those with low socioeconomic status, was observed for incident statin use. Incident atorvastatin use increased over time; simvastatin, cerivastatin, and rosuvastatin peaked and then declined; and new use of other statins decreased. Among 211,964 incident statin users, 74,542 (35.17%) had evidence of IHD only; 43,257 (20.41%) had DM but no IHD; 9781 (4.61%) had no DM or IHD but had atherosclerosis, cerebrovascular disease, or PVD; 47,634 (22.47%) had disorders of lipid metabolism only; and 36,750 (17.34%) had none of the medical conditions evaluated. CONCLUSIONS: Prevalent use (1996-2004) and incident use (1999-2004) of statins in an entire population have increased dramatically. Although many statin users (60.19%) had evidence of medical conditions that indicate appropriate statin use, 39.91% of users were at low risk for cardiovascular disease, and therefore the benefit of statins in this group remains small.