Cardiovascular Journal of Africa: Vol 30 No 6 (November/December 2019)

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CARDIOVASCULAR JOURNAL OF AFRICA • Volume 30, No 6, November/December 2019 340 AFRICA
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More aggressive statin therapy sometimes needed to fight ‘bad’ cholesterol
A study shows more aggressive treatment may be needed for
a large number of patients taking statin medications, and that
treatment could help reduce cases of cardiovascular disease,
the leading cause of death in the US.
High levels of low-density lipoprotein cholesterol (LDL-
C), sometimes called ‘bad’ cholesterol, are associated with
cardiovascular disease. The new research finds a third of
people in Indiana are not reaching a safe level of LDL-C
while taking statin medications.
The collaboration by researchers at Merck, known as
MSD outside the US and Canada, Regenstrief Institute,
Indiana University School of Medicine and the University
of North Carolina at Chapel Hill looked at electronic health
records in the state of Indiana and found that about a third
of people taking statins did not reach a therapeutic level of
LDL-C. The researchers say these patients seem to be at
an increased risk for cardiovascular disease events such as
heart attack and stroke, and may represent an important and
potentially preventable burden on healthcare costs.
Principal investigator and cardiologist from the University
of North Carolina, Dr Ross Simpson, Jr, says this study adds
to the body of evidence that many people are not getting
adequate treatment for high cholesterol levels. ‘This provides
an opportunity for improving care, whether it’s with higher
doses, more aggressive treatments or new therapies.’
The study set out to determine how many patients
on statins achieved the therapeutic threshold of LDL-C,
estimate the number of potentially avoidable cardiovascular
disease events if that threshold were reached, and forecast
potential healthcare cost savings.
The team examined electronic health records from the
Indiana Network for Patient Care for 86 000 patients who
started taking statins. They found 33.7% of those people
did not reach therapeutic levels of LDL-C (< 100 mg/dl =
2.59 mmol/l) after six to 18 months on therapy. In a high-
risk subgroup, 58% did not reach a more stringent LDL-C
standard (< 70 mg/dl = 1.81 mmol/l) commonly applied to
them. Among patients who regularly took their statin therapy
as directed, 24% of the full population and 51% of the high-
risk subgroup did not meet their respective thresholds.
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