Nathan D Wong1, Daphnee Young2, Yanglu Zhao2, Huy Nguyen2, Jared Caballes2, Irfan Khan3, Robert J Sanchez4. 1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA. Electronic address: ndwong@uci.edu. 2. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA, USA. 3. Global Health Economics and Outcomes Research, Sanofi, Bridgewater, NJ, USA. 4. Health Economics and Outcomes Research, Regeneron Pharmaceuticals Inc., Tarrytown, NY, USA.
Abstract
BACKGROUND: The 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline identifies 4 statin-eligible groups: (1) known atherosclerotic cardiovascular disease (ASCVD) aged ≥21 years, (2) low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL (4.9 mmol/L) aged ≥21 years, (3) diabetes mellitus aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L), or (4) ≥7.5% 10-year ASCVD risk aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L). OBJECTIVES: We examined the number of statin-eligible US adults, statin use, LDL-C goal attainment, and adherence to lifestyle management. METHODS: We identified subjects from the US National Health and Nutrition Examination Survey 2011-2012 in the 4 statin-eligible groups, proportion on statin, proportion at recommended LDL-C levels using National Lipid Association goals (<70 mg/dL [1.8 mmol/L] for very high risk and <100 mg/dL [2.6 mmol/L] for others), and adherence to lifestyle measures. RESULTS: Of 5206 adults (representing 219 million), 1677 adults representing 62.6 million adults fit into 1 of the 4 statin-eligible groups. Statin use was 63.7% for the ASCVD, 61.4% for the LDL-C ≥ 190 mg/dL (4.9 mmol/L), 43.2% for the diabetes mellitus, and 27.2% for the 10-year risk ≥7.5% groups. Of those on statins with LDL-C measured, 79.7%, 98.0%, 42.3%, and 46.8% were not at LDL-C goal. Adherence to recommended <6% calories from saturated fat ranged from 3.3% to 6.4% and ≥40 minutes of physical activity ≥3 times a week from 54.7% to 65.1% across statin-eligible groups. CONCLUSION: Many US adults eligible to receive statins based on American College of Cardiology/American Heart Association guidelines are not taking statins, and LDL-C levels still remain suboptimal.
BACKGROUND: The 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline identifies 4 statin-eligible groups: (1) known atherosclerotic cardiovascular disease (ASCVD) aged ≥21 years, (2) low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL (4.9 mmol/L) aged ≥21 years, (3) diabetes mellitus aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L), or (4) ≥7.5% 10-year ASCVD risk aged 40 to 75 years with LDL-C 70 to 189 mg/dL (1.8-4.9 mmol/L). OBJECTIVES: We examined the number of statin-eligible US adults, statin use, LDL-C goal attainment, and adherence to lifestyle management. METHODS: We identified subjects from the US National Health and Nutrition Examination Survey 2011-2012 in the 4 statin-eligible groups, proportion on statin, proportion at recommended LDL-C levels using National Lipid Association goals (<70 mg/dL [1.8 mmol/L] for very high risk and <100 mg/dL [2.6 mmol/L] for others), and adherence to lifestyle measures. RESULTS: Of 5206 adults (representing 219 million), 1677 adults representing 62.6 million adults fit into 1 of the 4 statin-eligible groups. Statin use was 63.7% for the ASCVD, 61.4% for the LDL-C ≥ 190 mg/dL (4.9 mmol/L), 43.2% for the diabetes mellitus, and 27.2% for the 10-year risk ≥7.5% groups. Of those on statins with LDL-C measured, 79.7%, 98.0%, 42.3%, and 46.8% were not at LDL-C goal. Adherence to recommended <6% calories from saturated fat ranged from 3.3% to 6.4% and ≥40 minutes of physical activity ≥3 times a week from 54.7% to 65.1% across statin-eligible groups. CONCLUSION: Many US adults eligible to receive statins based on American College of Cardiology/American Heart Association guidelines are not taking statins, and LDL-C levels still remain suboptimal.
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