Heart attack and stroke survivors neglect LDL cholesterol despite increased risk, finds survey

A 2023 survey from the American Heart Association conducted by The Harris Poll, found that a majority (70%) of heart attack and stroke survivors are unaware that LDL cholesterol is commonly referred to as 'bad cholesterol.' This matters because LDL cholesterol (low-density lipoprotein cholesterol) significantly contributes to the development of cardiovascular disease, increasing the risk of heart attacks and strokes. According to the Centers for Disease Control and Prevention, heart attack occurs every 40 seconds in the U.S.

The survey, conducted on behalf of the Association found that 75% of heart attack and stroke survivors reported having high cholesterol. However, only 49% recognized the need to prioritize lowering their cholesterol.

"There's a pervasive lack of public awareness and understanding around bad cholesterol and its impact on your cardiovascular health. As bad cholesterol usually has no symptoms, we often find that many patients are walking around without knowing they're at risk or how to mitigate it," said Joseph C. Wu, MD, PHD, FAHA, American Heart Association volunteer president and director, Stanford Cardiovascular Institute and Simon H. Stertzer, MD, Professor of Medicine & Radiology at Stanford School of Medicine.

Through its Lower Your LDL Cholesterol Now initiative, sponsored nationally by Amgen Inc., the American Heart Association is encouraging people to ask their doctor to check their cholesterol levels. In the Harris Poll study, 98% of heart attack and stroke survivors surveyed say they are willing to take a simple blood test if recommended by their health care professional.

"What's eye-opening about these survey results is that nearly half of those who have suffered a heart attack or stroke don't know their LDL cholesterol levels, which is a vital step in helping to prevent a second heart attack or stroke," said Paul Burton, M.D., Ph.D., senior vice president and chief medical officer, Amgen.

"Amgen is committed to working with other health care leaders, like the American Heart Association, to empower people to know more and do more about their cardiovascular disease. For patients, this starts with talking to your doctor about your LDL cholesterol number and appropriate steps for testing and treatment."

Among those who have experienced a heart attack and/or stroke, 69% say they have heard of LDL cholesterol. However, a substantial proportion (47%) remain unaware of their LDL number. LDL cholesterol plays a crucial role in the buildup of fatty deposits within arteries, leading to a condition known as atherosclerosis. This narrowing of arteries significantly escalates the risk of heart attacks, strokes, and peripheral artery disease (PAD).

"At the American Heart Association, we recommend that all adults 20 or older should have their cholesterol checked every 4 to 6 years as long as their risk remains low. After age 40, your health care professional will also want to use an equation to calculate your 10-year risk of having a heart attack or stroke. People who have had a prior heart attack or stroke may need their cholesterol checked more often," said Donald M. Lloyd-Jones, M.D., Sc.M., FAHA, past volunteer president of the American Heart Association and chair of the department of preventive medicine, the Eileen M. Foell Professor of Heart Research and professor of preventive medicine, medicine and pediatrics at Northwestern University's Feinberg School of Medicine in Chicago.

"This is very much a case where knowledge is power. The more you know, the more you can do to decrease your risk of heart attack and stroke in the future."

An encouraging finding from the survey is that 65% of heart attack and stroke survivors polled correctly believe high cholesterol poses a moderate to high increased risk for heart attack and stroke.

"However, there's still progress to be made," emphasizes Lloyd-Jones, "as this statistic underlines that a considerable portion of survivors require further understanding, particularly regarding the specific risk associated with LDL cholesterol. It's essential for heart attack and stroke survivors to grasp the profound impact of high LDL cholesterol, often referred to as the 'bad' cholesterol, on their cardiovascular health."

According to American Heart Association guidelines, lifestyle habits like eating a healthy and balanced diet, regular exercise and eliminating tobacco use can all help you control your cholesterol and should be the first line of defense. However, some individuals, especially heart attack and stroke survivors, should have a conversation with their doctor about cholesterol-lowering medications. There are also several medications available including statins, PCSK9 targeting agents, Ezetimibe, Bile Acid Sequestrants, and ATP citrate lyase (ACLY) Inhibitors.