Treatment rates for dangerously high cholesterol remain low

Though a significant amount of literature currently exists regarding high cholesterol as a risk factor for cardiovascular disease (CVD), less than 40 percent of people with high cholesterol levels are prescribed the correct drug treatments, according to new research published in the American Heart Association’s journal Circulation.

The frequency of self-reported cholesterol screening and awareness of cholesterol are 80 percent among American adults, but only 38 percent of people with high cholesterol levels are prescribed the correct drug treatments.

Additionally, researchers also found that only 30 percent of patients with severely elevated cholesterol are prescribed a high-intensity statin.

“Our findings are consistent with those of prior studies demonstrating suboptimal rates of statin prescription in patients with heterozygous FH (familial hypercholesterolemia) or severe dyslipidemia,” wrote lead author Emily Bucholz, MD, PhD, of Boston Children’s Hospital and colleagues.

Using data from the 1999-2014 National Health and Nutrition Examination Survey, researchers estimated the occurrence of self-reported screening, awareness and statin therapy in more than 42,000 American adults 20 and older with severely elevated LDL cholesterol levels (190 mg/dL or higher).

Of the study group, younger patients had the biggest discrepancy between screening and treatment.

“Young adults aged 20 to 39 years may be at particularly high risk of being undertreated given their lower rates of insurance and having a usual source of care in this study,” the authors wrote. “In addition, 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.”

Additionally, researchers studied a subgroup of patients with FH—a genetic disorder that causes severe elevation in cholesterol which leads to an increased risk of early CVD. However, the national prevalence of screening, awareness and statin treatment for individuals with FH is unknown.

“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,” Bucholz et al concluded.