Many of those eligible for cholesterol-lowering interventions are not taking them up.
From 2007-14 there was a decline in the rate of high blood levels of cholesterol among Americans, and there has been a recent increase in the use of cholesterol-lowering medications.
In the US, there are 78.1 million adults with high LDL cholesterol and a risk of heart disease.
These people are advised to take preventive action combining cholesterol-lowering medications with lifestyle changes, such as regular exercise, a heart-healthy diet and weight loss.
Yet, fewer than half of those eligible for the medications are taking them, and fewer than half make the recommended lifestyle changes.
Black people and Mexican Americans are particularly affected.
Who should take the medication?
The American College of Cardiology (ACC) and the American Heart Association (AHA) recommend cholesterol-lowering medications for:
- Heart disease, a prior heart attack or some types of stroke, or angina
- LDL cholesterol levels of 190 mg/dL or more
- Diabetes plus LDL cholesterol levels of 70-189 mg/dL in those aged 40-75 years
- LDL cholesterol levels of 70-189 mg/dL and an estimated 10-year risk of heart disease of 7.5% or more in those aged 40-75 years.
Researchers from the Centers for Disease Control and Prevention (CDC) examined data from the 2005-12 National Health and Nutrition Examination Surveys.
How many people follow the advice?
Overall, 36.7% of adults in the US aged 21 years and older were eligible for cholesterol-lowering medication or were already taking it.
Of these, 55.5% were currently taking cholesterol-lowering medication, and 46.6% reported making lifestyle changes; 37.1% reported making lifestyle modifications and taking medication; 35.5% were doing neither.
Gender, race and ethnicity made a difference:
- Of 40.8% of all men eligible for or already on medication, 52.9% were taking it
- Of 32.9% of all women eligible for or already on medication, 58.6% were taking it
- Of 24.2% of all Mexican-Americans eligible for or already on medication, 47.1% were taking it
- Of 39.5% of all black adults eligible for or already on medication, 46% were taking it
- Of 38.4% of all white adults eligible for or already on medication, 58% were taking it.
Black people who did not have a routine place for health care had the lowest rate of taking recommended cholesterol-lowering medication, at 5.7%.
People who had adopted a heart-healthy lifestyle were most likely to be taking cholesterol-lowering medication, at 80%.
Dr. Carla Mercado, a scientist in the CDC's Division for Heart Disease and Stroke Prevention, says:
"Nearly 800,000 people die in the US each year from cardiovascular diseases, that is 1 in every 3 deaths, and high cholesterol continues to be a major risk factor. This study reveals opportunities to reduce existing disparities through targeted patient education and cholesterol-management programs."
The US Department of Health and Human Services' "Million Hearts" initiative aims to prevent 1 million heart attacks and strokes by 2017 through various targets, including getting 65% of Americans to manage their high LDL cholesterol.
While the study included all forms of cholesterol-lowering medication, a statin was used in nearly 90% of cases.
Medical News Today recently reported on research showing that many people give up using statins as a result of negative news stories about the drugs.