Barriers in utilizing lipid-lowering agents in non-institutionalized population in the U.S.: Application of a theoretical framework

Abstract

Cardiovascular diseases are a major cause of death globally. Epidemiological evidence has linked elevated levels of blood cholesterol with the risk of coronary heart disease. However, lipid-lowering agents, despite their importance for primary prevention, are significantly underused in the United States. The objective of this study was to explore associations among socioeconomic factors and the use of antihyperlipidemic agents in 2018 in U.S. patients with hyperlipidemia by applying a theoretical framework. Data from the 2018 Medical Expenditure Panel Survey were used to identify the population of non-institutionalized U.S. civilians diagnosed with hyperlipidemia. This cross sectional study applied the Andersen Behavioral Model to identify patients’ predisposing, enabling, and need factors. Approximately 43 million non-institutionalized adults were diagnosed with hyperlipidemia. With the exception of gender and race, predisposing factors indicated significant differences between patients who used antihyperlipidemic agents and those who did not. The relation between income level and use of antihyperlipidemic agents was significant: X2 (4, N = 3,781) = 7.09, p <.001. Hispanic patients were found to be less likely to receive treatment (OR: 0.62; 95% CI: 0.43–0.88), as observed using a logistic model, with controls for predisposing, enabling, and need factors. Patients without health insurance were less likely to use lipid-lowering agents (OR: 0.33; 95% CI: 0.14–0.77). The present study offers essential data for prioritizing interventions by health policy makers by identifying barriers in utilizing hyperlipidemia therapy. Non-adherence to treatment may lead to severe consequences and increase the frequency of fatal cardiac events in the near future.

State-Level Cardiovascular Mortality Rates Among Hispanic, Non-Hispanic Black, and Non-Hispanic White Populations, 1990 to 2019

“…31 Eliminating observed health disparities will require a multisectoral approach: community engagement for healthy lifestyle interventions, such as access to affordable healthy food options and safe neighborhoods that promote increased physical activity; government-level policies to address systemic racism and health inequities; and efforts to provide equitable access to medical care, including removing structural barriers and reluctance to seek medical care. [32][33][34][35][36]…”

Effects of Mangifera indica leaves improves blood lipids profile and biochemical indices in high-fat diet-induced hyperlipidaemia rats

“…Hyperlipidaemia is very often involved in dyslipidaemia, which have abnormalities in one or more parameter of the biochemical lipid triad [1] . It has previously been shown that excess intake of HFD can be at increased risk for abnormal lipid homeostasis [2] .…”