scholarly journals Is High-Intensity Statin Therapy Associated With Lower Statin Adherence Compared With Low- to Moderate-Intensity Statin Therapy? Implications of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guidelines

2014 ◽  
Vol 37 (11) ◽  
pp. 653-659 ◽  
Author(s):  
Salim S. Virani ◽  
LeChauncy D. Woodard ◽  
Julia M. Akeroyd ◽  
David J. Ramsey ◽  
Christie M. Ballantyne ◽  
...  
Keyword(s):  
Statin Therapy ◽  
High Intensity ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Moderate Intensity ◽  
Management Guidelines ◽  
Cholesterol Management ◽  
Statin Adherence

Abstract 15632: The Implications of the Recent American College of Cardiology/American Heart Association Guidelines for the Treatment of Blood Cholesterol on a Rural Community: The Heart of New Ulm Project

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Michael D Miedema ◽  
Abbey C Sidebottom ◽  
Arthur Sillah ◽  
Gretchen Benson ◽  
Jackie Boucher ◽  
...  
Keyword(s):  
Statin Therapy ◽  
High Intensity ◽  
American Heart Association ◽  
Census Data ◽  
American Heart ◽  
Heart Association ◽  
Blood Cholesterol ◽  
Lipid Lowering ◽  
New Guidelines ◽  
The Impact

Introduction: The impact of the new American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines on the volume of statin-eligible patients requires further analysis, particularly in rural communities who are rarely included in traditional large observational cohorts. Methods: We performed a cross-sectional analysis using data from the Heart of New Ulm Project, a population-based program aimed at reducing modifiable cardiovascular disease (CVD) risk factors in rural New Ulm, MN. According to 2010 census data, there were 7,855 adults aged 40-79 years in the target population at that time. The community is served by one health and electronic health records (EHR) system. EHR-based demographics, diagnoses, and medications were analyzed in residents aged 40-79 years in 2012-2013. The prevalence of indications for statin therapy and of use of statins and other lipid-lowering medications were analyzed according to the ACC/AHA guidelines. Results: There were 6,357 residents with a visit during the study period, of which 4,281 had adequate data and were included in the analysis (mean age 59.4 [10.2] years, 52.7% female). In our study sample, 2,529 (59%) met one of the 4 major indications for statin therapy (Table). Of those with an indication, 65% were on a statin, 11% were on a high-intensity statin, and 5% on other lipid-lowering agents. An age stratified analysis demonstrated that 86% of individuals 60-79 years old (n=2,036) are now statin-eligible compared to 35% of individuals 40-59 years old (n=2,245). Conclusion: Using contemporary EHR data from a rural Midwest community, approximately 3 in 5 middle-age residents qualify for statin therapy according to the new guidelines, but only two-thirds of those individuals were taking a statin. Full compliance with the new guidelines will require a significant increase in statin utilization, including more frequent use of high-intensity statins.

scholarly journals Impact of the American College of Cardiology/American Heart Association Cholesterol Guidelines on Statin Eligibility Among Human Immunodeficiency Virus-Infected Individuals

2018 ◽  
Vol 5 (12) ◽  
Author(s):  
Mosepele Mosepele ◽  
Susan Regan ◽  
Joseph Massaro ◽  
James B Meigs ◽  
Markella V Zanni ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Statin Therapy ◽  
American Heart Association ◽  
American Heart ◽  
Clinical Care ◽  
Heart Association ◽  
Cvd Risk ◽  
Immunodeficiency Virus ◽  
Statin Prescription ◽  
Cholesterol Guidelines

Abstract Background Individuals with human immunodeficiency virus (HIV) face elevated cardiovascular disease (CVD) risk. There are limited data regarding the application of the American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines in HIV compared with non-HIV patients. Methods Human immunodeficiency virus-infected and demographically similar control patients were assessed for statin recommendation status by ACC/AHA and the National Cholesterol Education Program Adult Treatment Program III (ATPIII), indication for statin recommendation, actual statin prescription, and CVD event. Outcomes were atherosclerotic CVD for ACC/AHA and coronary heart disease for ATPIII. Results In a clinical care cohort of 1394 patients infected with HIV, 38.6% (538 of 1394) of patients were recommended for statin therapy by the ACC/AHA guidelines compared with 20.1% (280 of 1394) by the ATPIII guidelines. Of those recommended for statin therapy, actual statin prescription rates were 42.8% (230 of 538) for ACC/AHA and 66.4% (186 of 280) for ATPIII. Among patients infected with HIV with an incident CVD event during follow-up, statin therapy was recommended for 59.2% (42 of 71) of patients by ACC/AHA and 35.2% (25 of 71) by ATPIII, versus 71.6% (141 of 197) by ACC/AHA and 43.1% (85 of 197) by ATPIII in the control group. Conclusions In an HIV clinical care cohort, the ACC/AHA cholesterol guidelines recommend a higher proportion of patients for statin therapy and identify an increased proportion of patients with a CVD event compared with ATPIII. However, 40% of patients with a CVD event would not have been recommended for statin therapy by ACC/AHA, compared with 29% for controls. This gap in identification of patients infected with HIV at high CVD risk underscores the need for HIV-specific cardiovascular prevention strategies.

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