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Bridging the treatment gap
1Division of Cardiology, University of North Carolina Cardiovascular Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7075, USA.
Insights
Cardiovascular disease (CVD) is a leading cause of death. Making cholesterol-lowering statins available over-the-counter (OTC) could improve treatment rates and reduce heart disease risk for many patients.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Public Health
Background:
- Cardiovascular disease (CVD) is the primary cause of death and disability in the U.S.
- Hypercholesterolemia, a major risk factor for CVD, is significantly undertreated.
- Lowering low-density lipoprotein (LDL) cholesterol by 25-35% demonstrably reduces morbidity and mortality.
Purpose of the Study:
- To evaluate the potential benefits of increased availability of cholesterol-lowering therapies.
- To explore consumer interest in over-the-counter (OTC) statin products.
- To address suboptimal outcomes in CVD prevention due to undertreatment.
Main Methods:
- Analysis of current prescribing practices and treatment guidelines for cholesterol-lowering agents.
- Review of consumer surveys regarding interest in OTC cholesterol-lowering products.
- Assessment of the efficacy, safety, and accessibility of statin therapy.
Main Results:
- Current treatment rates for hypercholesterolemia remain low, impacting CVD prevention outcomes.
- A significant portion of patients with high cholesterol express interest in OTC statin options.
- Wider access to lipid-lowering agents could improve patient outcomes.
Conclusions:
- Increased availability of cholesterol-lowering therapies, potentially via OTC statins, could enhance CVD prevention.
- Proposed advantages of OTC statins include proven efficacy, safety, and dose consistency.
- Changes in prescribing practices and expanded access are needed to improve population-level cardiovascular health.
Abstract:
The leading cause of death and disability in the United States today is cardiovascular disease (CVD). The main risk factor, hypercholesterolemia, is grossly undertreated, although it is widely appreciated that lowering cholesterol levels is key to reducing the incidence of CVD. Cholesterol-lowering therapy decreases total mortality, cardiovascular events, the need for revascularization procedures, and hospitalization costs. A 25-35% reduction of low-density lipoprotein (LDL) indicates significant benefits with regard to morbidity and mortality. Unfortunately, most patients who are candidates for cholesterol-lowering treatment do not receive it. Wider use of lipid-lowering agents could, in fact, make a significant difference in patient outcomes. There is strong interest on the part of consumers in over-the-counter (OTC) cholesterol-lowering products that may help them reduce their risk of developing heart disease and live healthier lives. Surveys estimate that half of all patients with high cholesterol would like to have an OTC statin product made available. Increased availability of cholesterol-lowering therapies as well as changes in physician prescribing practices could benefit a broad spectrum of the population that is currently untreated or undertreated. Current prescribing practices and guidelines have not resulted in widespread use of these therapies; therefore, outcomes for CVD prevention remains suboptimal. The proposed advantages of making statins available over-the-counter include their known efficacy, dose consistency, and proven safety profile.