Nearly Half of US Patients Eligible for Cholesterol Treatment Not Taking Meds, Says CDC

Deborah Brauser

December 06, 2015

ATLANTA, GA — Between 2005 and 2012, only 45% of 78.1 million adults eligible for cholesterol-lowering medications actually took them, according to new data from the Centers for Disease Control and Prevention (CDC)[1].

This neglect was especially prevalent in black and Mexican American patients, both of whom were significantly less likely to take this type of medication compared with whites (P<0.001), according to a study published in the December 4, 2015 issue of the CDC's Morbidity and Mortality Weekly Report. In addition, men were less likely to take cholesterol-lowering medications than women (P=0.01).

"Further efforts by clinicians and public-health practitioners are needed to implement complementary and targeted patient-education and disease-management programs to reduce sex and racial/ethnic disparities," write the investigators, led by Dr Carla Mercado (National Center for Chronic Disease Prevention and Health Promotion, CDC).

Identification Crucial

The investigators note that 2013 guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) on cholesterol management recommend both lifestyle modifications and use of medication. "As more providers implement the 2013 ACC/AHA guidelines, it is important to describe persons currently eligible for treatment," they write.

After assessing data from the National Health and Nutrition Examination Surveys (NHANES) for the years 2005 to 2012, they found that 36.7% of US adults over the age of 21 years were either on or eligible for cholesterol-lowering treatment. Within this patient group:

  • 55.5% were taking cholesterol medication.

  • 46.6% were making lifestyle modifications.

  • 37.1% were doing both.

  • And 35.5% were doing neither.

In addition, the women in this group were more likely than the men to take medication (58.6% vs 52.9%, respectively), and whites (58%) were more likely than Mexican Americans (47.1%) and blacks (46%) to take the treatment.

There were also significant differences in use based on <100% vs >500% poverty-to-income ratio (46.5% vs 58.9%, respectively; P=0.03), age group (41.3% of those 21–39 vs 62.7% of those over 65 years, P<0.001), and body-mass index (BMI) category (59.6% of those considered obese vs 52.3% of overweight or 52.6% of normal-weight participants, P=0.008).

Significantly more of the treatment-eligible participants who had diabetes or hypertension took cholesterol-lowering medication vs those without the conditions (P<0.001 for both comparisons).

Finally, 93% of the eligible participants with the lowest LDL-cholesterol levels (<70 mg/dL) took the medication vs 74% of those with levels of 70 to 100 mg/dL, 43% of those with levels of 100 to 189 mg/dL, and 22% of those with levels of 190 mg/dL or greater.

"Coordinated . . . clinical programs are needed to better identify all persons now eligible for cholesterol treatment," write the researchers, adding that screening and management can be improved by incorporating "evidence-based interventions" from the Guide to Community Preventive Services.


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