Nearly half of Americans whose cholesterol readings put them at higher risk of heart attack or stroke are not taking medication to drive down that risk, says a new study by the Centers for Disease Control and Prevention.
CDC researchers examined data from the 2005-2012 National Health and Nutrition Examination Surveys (NHANES is an ongoing national survey using a complex, multistage, probability sampling design to measure the health and nutritional status of the noninstitutionalized U.S. population.) The CDC publication's main thrust is that too few of those Americans who should be taking a cholesterol-lowering agent are actually doing so.
Low-cost and generally safe statin drugs have been shown to drive down the rates of heart attack and stroke. Overall, 36.7 percent of U.S. adults 78.1 million people age 21 or older were eligible for cholesterol-lowering medication or already taking it. Within this group, 55.5 percent were currently taking cholesterol-lowering medication and 46.6 percent reported making lifestyle changes; 37.1 percent reported making lifestyle modifications and taking medication, and 35.5 percent reported doing neither.
Between 2000 and 2014, the fraction of Americans with elevated blood levels of cholesterol declined from 18.3 percent to 11 percent, almost certainly due to an increase in the use of cholesterol-lowering medications: the use of any lipid-lowering agent was 20 percent in 2004; the data from 2012 showed that 28 percent of Americans over age 40 are taking such a medication. But a high blood level of LDL cholesterol also known as bad cholesterol remains a major risk factor for heart disease and stroke in the U.S.
Nearly 800,000 people die in the U.S. each year from cardiovascular diseases that s one in every three deaths and high cholesterol continues to be a major risk factor, said Dr. Carla Mercado, a scientist in CDC s Division for Heart Disease and Stroke Prevention. This study reveals opportunities to reduce existing disparities through targeted patient education and cholesterol management programs.
Getting 65 percent of Americans to manage their high levels of LDL cholesterol by 2017 can prevent one million heart attacks and strokes, according to the CDC.
The American College of Cardiology and the American Heart Association recommend cholesterol-lowering medication for four groups of adults:
- People with heart disease, a prior heart attack or some types of stroke, or angina.
- People with LDL cholesterol levels of 190 mg/dL or more.
- People ages 40 to 75 with diabetes and LDL cholesterol levels of 70-189 mg/dL.
- People ages 40-75 with LDL cholesterol levels of 70-189 mg/dL and an estimated 10-year risk of heart disease of 7.5 percent or more (risk calculator is available here.
Statin drugs are typically the first choice to drive down elevated levels of "bad" cholesterol, LDL, and there are several effective brands on generic labels and thus quite inexpensive. While these results are of concern, they also present a clear opportunity for more intensive and effective educational efforts by the CDC and other public health communicators to advise doctors and the public about having their cholesterol levels checked and taking medication when indicated.