Prevalence of Cholesterol Treatment Eligibility and Medication Use Among Adults — United States, 2005–2012

Mercado, Carla; DeSimone, Ariadne K.; Odom, Erika; Gillespie, Cathleen; Ayala, Carma; Loustalot, Fleetwood

doi:10.15585/mmwr.mm6447a1

Cited by 67 publications

(59 citation statements)

References 8 publications

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“…We did not include the riskbased benefit group, for which controversy persists due to poor calibration of the pooled cohort equations in some populations. In a nonveteran real-world cohort, the statin underprescription may be higher than that described by Clement et al, and is in concordance with the data reported from the National Health and Nutrition Examination Survey [3]. We also highlight the gender gap in statin utilization, especially among those with HIV, which requires further investigation.…”

supporting

confidence: 90%

Gender Differences in Statin Prescription Rate Among Patients Living With HIV and Hepatitis C Virus

et al. 2016

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supporting

confidence: 90%

Gender Differences in Statin Prescription Rate Among Patients Living With HIV and Hepatitis C Virus

et al. 2016

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“…58 Of even more concern though, is that recent reports have identified sex-specific differences in both treatment and adherence to lipid-lowering medications; women are less likely to be prescribed statin therapy 59, 60 , and compliance is variable. 61 Reasons for this disparity are unclear at the present time, but underscore the need for additional physician and patient awareness of the benefits of lipid-lowering therapy in women.…”

Section: Traditional Ascvd Risk Factors In Women (Table 1)mentioning

confidence: 99%

“…Among persons on or eligible for treatment there were major differences in the proportion of men (52.9%) and women (58.6) taking cholesterol-lowering medication. 58 There is no compelling evidence to support that statins are less safe in women than in men. The guidelines recommend baseline ALT level assessment, but unless there is suspected hepatic dysfunction, monitoring is not needed.…”

Section: Primary Prevention Guidelinesmentioning

confidence: 99%

Cardiovascular Disease in Women

García

Mulvagh

Merz

et al. 2016

Circulation Research

801

680

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Cardiovascular disease (CVD) continues to be the leading cause of death among women in the United States, accounting for approximately one of every three female deaths. Sex-specific data focused on CVD has been increasing steadily, yet is not routinely collected nor translated into practice. This comprehensive review focuses on novel and unique aspects of cardiovascular health in women and sex-differences as they relate to clinical practice in the prevention, diagnosis, and treatment of CVD. This review also provides current approaches to the evaluation and treatment of acute coronary syndromes that are more prevalent in women, including: myocardial infarction associated with non-obstructive coronary arteries, spontaneous coronary artery dissection, and stress-induced cardiomyopathy (Takotsubo Syndrome). Other CVD entities with higher prevalence or unique considerations in women, such as heart failure with preserved ejection fraction, peripheral arterial disease and abdominal aortic aneurysms, are also briefly reviewed. Lastly, recommendations for cardiac rehabilitation are addressed.

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“…According to the CDC, approximately 78 million Americans (>21 years age) are eligible for cholesterol lowering medication, but only 55% are taking such therapy, of whom about 90% are on a statin [2]. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors such as alirocumab (ALI) and evolocumab (EVO) have transformed LDLC lowering [3].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, Low density lipoprotein cholesterol lowering, and calculated 10-year cardiovascular risk reduction of alirocumab and evolocumab in addition to maximal tolerated cholesterol lowering therapy: a post-commercialization study

et al. 2017

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BackgroundEfficacy and safety of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, alirocumab (ALI) and evolocumab (EVO) have previously been evaluated through controlled clinical trials with selective patient groups. Post-commercially, in patients with heterozygous familial hypercholesterolemia (HeFH) and/or cardiovascular disease (CVD) with suboptimal LDL cholesterol (LDLC) lowering on maximal tolerated cholesterol lowering therapy, we assessed efficacy and safety of ALI and EVO.MethodsPost-commercially, we started 25 patients on ALI 75 mg, 15 on ALI 150 mg, and 32 on EVO 140 mg bi-weekly added to entry LDLC lowering regimen, with follow-up for a median 24 weeks. History, physical exam, demographics, and adverse event data were collected. Changes in LDLC and AHA and NIH calculated 10-year CVD risks were assessed on ALI and EVO.ResultsOf 72 patients, 25 had HeFH only, 25 CVD only, 22 had both, median age was 65 years, 63% females, 38% males, 86% Caucasian, 11% African-Americans, 17% diabetics, 63% on anti-hypertensives, and 7% smokers. At entry, 30 (42%) were on a statin and 42 (58%) could not tolerate any statins.At 24-weeks, median LDLC decreased on ALI 75 mg from 117 to 62 mg/dL (−54%), on ALI 150 mg from 175 to 57 mg/dL (−63%), and on EVO 140 mg from 165 to 69 mg/dL (−63%), p <0.0001 for all. Absolute and percent LDLC reduction did not differ (p >.05) between ALI 150 and EVO 140 mg, but were less on ALI 75 mg vs ALI 150 mg and EVO 140 mg (p <.05).Percent reductions in 10-year CVD risks by AHA and NIH calculators, respectively were ALI 75 mg −22 and −44%, ALI 150 mg −31 and −50%, and EVO 140 mg −29 and −56%, p ≤.002 for all.The three most common adverse events included flu-like myositis 10%, respiratory tract symptoms 8%, and injection site reaction 6%.ConclusionIn patients with HeFH and/or CVD, LDLC was lowered by 63% on EVO and ALI 150 mg, and 54% on ALI 75 mg. Adverse events were minimal and tolerable. ALI and EVO represent paradigm shifts in LDLC lowering. Long term, post-commercial safety and efficacy remain to be determined.

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Prevalence of Cholesterol Treatment Eligibility and Medication Use Among Adults — United States, 2005–2012

Cited by 67 publications

References 8 publications

Gender Differences in Statin Prescription Rate Among Patients Living With HIV and Hepatitis C Virus

Gender Differences in Statin Prescription Rate Among Patients Living With HIV and Hepatitis C Virus

Cardiovascular Disease in Women

Efficacy, safety, Low density lipoprotein cholesterol lowering, and calculated 10-year cardiovascular risk reduction of alirocumab and evolocumab in addition to maximal tolerated cholesterol lowering therapy: a post-commercialization study

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