Lipid-lowering drugs save lives, but use decreasing

Lipid-lowering drugs for primary prevention are associated with a significant survival benefit, but use has decreased over time, according to a study published online Nov. 16 in Circulation.

Jeremy Miles, M.D., from the Montefiore Healthcare Network/Albert Einstein College of Medicine in New York City, and colleagues evaluated the predictors of long-term mortality in a large racially and ethnically diverse U.S. patient cohort with low-density lipoprotein cholesterol ≥190 mg/dL. The analysis included 18,740 patients (2010 through 2020).

The researchers found that high-density lipoprotein cholesterol and body mass index extremes were associated with higher mortality. Higher low-density lipoprotein cholesterol and triglyceride levels were associated with an increased nine-year mortality risk in adjusted models. Higher mortality was associated with clinical factors such as male sex, older age, hypertension, chronic kidney disease, diabetes, heart failure, myocardial infarction, and body mass index.

A significant survival benefit was seen with lipid-lowering therapy. High-density lipoprotein cholesterol <40 mg/dL was independently associated with higher mortality. Over time, there was a significant reduction noted in statin use: 56 percent of patients on primary prevention and 85 percent of those on secondary prevention were on statin therapy from 2019 to 2020.

"Our results support efforts geared toward early recognition and consistent treatment for patients with severe hypercholesterolemia," the authors write.

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