In recent study, 23 percent of NHANES primary prevention cohort currently using lipid-lowering therapies versus 47 percent eligible under U.S. guidelines
By Elana Gotkine HealthDay Reporter
THURSDAY, July 10, 2025 (HealthDay News) — Pharmacologic treatment of hypercholesterolemia falls short of U.S. and European guidelines, according to a study published online June 30 in the Journal of General Internal Medicine.
G. Caleb Alexander, M.D., from Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues projected anticipated improvements in treatment and outcomes of hypercholesterolemia under full implementation of U.S. and European pharmacologic treatment recommendations in a study of 4,980 adults aged 40 to 75 years from the 2013 through March 2020 National Health and Nutrition Examination Survey (NHANES). The number of individuals eligible to receive versus currently receiving lipid-lowering therapy (LLT) was examined after applying the 2018 U.S. guideline, the 2019 European Union guideline, and the 2022 U.S. pathway.
The researchers found that 23 percent of the NHANES primary prevention cohort was currently using LLT compared with 47 percent eligible with the 2018 U.S. guideline/2022 U.S. pathway and 87 percent eligible with the 2019 EU guideline. For all therapies, the percentage with LLT use was significantly lower than the proportion of eligible patients. Based on the 2018 U.S. guideline, 2019 EU guideline, and 2022 U.S. pathway, the additional overall median reduction in low-density lipoprotein cholesterol expected under fully guideline-concordant care was 37.2, 48.5, and 46.8 mg/dL, respectively, potentially yielding a 21 to 27 percent relative reduction in the risk for major cardiovascular events.
“These results add to a growing body of evidence that there are important shortcomings in the quality of care for common and costly chronic diseases such as high cholesterol, and that addressing those shortcomings would yield major public health benefits,” Alexander said in a statement.
Several authors disclosed ties to pharmaceutical companies, including Merck, which partially funded the study.
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