small dense LDL
Total annual cost of CVD in 2014-2015
How often in seconds an MI happens in America
Number of Americans age 20 and older that have CAD
How often in seconds a death from CVD happens in America
Source: AHA 2019 Heart Disease and Stroke Statistics and Centers for Disease Control
Despite the advances in CVD treatments...
Cardiovascular disease continues to be the leading cause of death, not only in the US, but globally. As highlighted above, the numbers are staggering, and CVD remains a significant burden economically, irrespective of country or region.
While there have been medical achievements in greatly improving diagnosis and treatment of CVD, there's still a great divide to cross in order to make an impact in slowing disease progression. Clinical practice guidelines incorporate evidence-based science and medicine in the management of CVD but adherence by the medical community is well below expectations, which is one critical element in the deployment of timely care.
As healthcare systems wrestle with the challenges of CVD, it is clear that more must be achieved for those afflicted, and just as importantly, for the apparently healthy.
Treatment and Non-Adherence
Statins are effective and proven to lower LDL-C, and as result, decrease the risk of developing disease. However, according to a recent literature review, adherence to statin treatment is abysmal, with 59.1% of patients not taking or consistently not complying with the treatment. Moreover, in those patients who have had a myocardial infarct, only 44% remained on statin therapy after 6-12 months.
Further complicating the situation, clinicians are not consistent in the deployment of care, even when it is evidence-based. Clinical practice guidelines highlight that statin is a class I recommendation for individuals with ASCVD. Yet, according to a cross-sectional study in JAHA, Bradley, et al, revealed in the PALM study that 26.5% were not on treatment. Of those not on statins, nearly 60% of patients were never offered statins. However, most alarming was that of those who had ASCVD -- 30% were never offered statin therapy.
This gap in management is concerning and is a clear indication that there are numerous areas that require immediate attention in order improve outcomes.
However, most alarming were those that had ASCVD, 30% were never offered statin therapy.