Patients at high risk of stroke and heart attack under-treated – study

Real-world analysis by the Family Heart Foundation has revealed that the majority of Americans at high risk of stroke and heart attack remain under-treated.

According to a new study from the Family Heart Foundation, a leading research and advocacy organization, over 72 per cent of high-risk hypercholesterolemia patients never achieve the low-density lipoprotein-cholesterol (LDL-C) thresholds recommended in the 2018 American College of Cardiology/American Heart Association Guideline on the Management of Blood Cholesterol. 

This may be due to a lack of physician prescribing, insurance coverage and patient follow through, despite the known risk of cardiovascular disease. 

Based on real-world data from an analysis of the Family Heart DatabaseTM of more than 300 million Americans, the findings were highlighted at the American College of Cardiology 2023 conference on 4 March 2023 in New Orleans.

Additional key findings from the study show that only 27.8 per cent of all high-risk patients ever reached below-guideline LDL-C thresholds. For those with episodes below LDL-C thresholds, the mean duration of each episode was 158.8 days.

In addition, 79.5 per cent of clinicians never prescribed combination cholesterol-lowering medications though the guideline provides direction and rationale for doing so. Only 2.2 per cent of high-risk patients received combination cholesterol-lowering medications.

The observational study assessed achievement of LDL-C below thresholds in 38,110,734 high-risk patients.

The Family Heart Database is made up of real-world diagnostic, procedural, and prescription data from claims and/or laboratory information in the US from 2012 to 2021.

Dr Mary P McGowan, chief medical officer, Family Heart Foundation and co-author of the study, commented: “This study provides us with a clear view of the poor state of LDL cholesterol management for high-risk individuals in the United States.

“Despite the availability of safe and effective lipid-lowering therapies, only 28 per cent of high-risk patients ever reach below guideline LDL-C thresholds, which further elevates these patients’ risks for atherosclerotic cardiovascular disease (ASCVD) events, such as heart attacks and stroke.”