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Treatment for severely elevated cholesterol remains low
Cholesterol screenings and awareness are prevalent in the cardiology community, but treatment rates for significantly high cholesterol remain low, according to results recently published in Circulation.
The nationally representative study reported that less than 40% of people with severe elevations are prescribed appropriate drug treatment, and these rates were particularly low among younger patients.
“Young adults may be less likely to think that they are at risk of cardiovascular disease, and clinicians may be less likely to initiate statin therapy in this population,” Emily M. Bucholz, MD, PhD, MPH, from the department of medicine at Boston Children’s Hospital, said in a press release. “It is possible that lifestyle modifications continue to be prescribed as an initial treatment prior to initiating statin therapy.”
The researchers used data from the 1999-2014 National Health and Nutrition Examination Survey to estimate prevalence rates of self-reported screening, awareness and statin therapy among 42,471 U.S. adults with familial hypercholesterolemia (FH) and severe dyslipidemia.
Bucholz and colleagues used logistic regression to identify sociodemographic and clinical correlates of hypercholesterolemia awareness and statin therapy.
The researchers found that estimated U.S. prevalence of definite/probable FH was 0.47% (standard error, 0.03%), and for severe dyslipidemia, prevalence was 6.6% (standard error, 0.2%).
The frequency of cholesterol screening and awareness was more than 80% among adults with definite/probable FH or severe dyslipidemia. Statin use, however, was low (52.3%; standard error, 8.2%)) among adults with definite/probable FH and adults with severe dyslipidemia (37.6%; standard error, 1.2%), according to the data.
Only 30.3% of patients with definite/probable FH on statins were adhering to a high-intensity statin prescription, the researchers wrote.
There was an increase in prevalence of statin use in adults with severe dyslipidemia over time (from 29.4% to 47.7%) but it was not faster than the increase observed in the general population (from 5.7% to 17.6%), Bucholz and colleagues wrote.
There was an association between higher statin use and older age, health insurance status, having a usual source of care, diabetes, hypertension and having a personal history of early atherosclerotic CVD, according to the researchers.
“Given the cardiovascular morbidity and mortality associated with FH and other severe dyslipidemias and the benefits of statin therapy among such patients, current rates of stain therapy in U.S. adults with FH/severe dyslipidemia are too low,” the researchers wrote. “Further studies need to investigate strategies to improve treatment among adults with FH and severe dyslipidemia, particularly among younger adults and those with limited access to care.” − by Dave Quaile
Disclosures: The authors report no relevant financial disclosures.