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Statins Versus Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors- Are We Doing Better? A Systematic Review on

Chetana Singh1, Danel J Valero2, Javariya Nisar3

  • 1Primary Care, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

Cureus
|November 19, 2020
PubMed

Insights

Racial and gender disparities exist in hyperlipidemia treatment. Non-white individuals and women received less guideline-directed therapy, impacting coronary artery disease (CAD) risk factor management.

Area of Science:

  • Cardiovascular Medicine
  • Health Disparities Research
  • Pharmacotherapy

Background:

  • Coronary artery disease (CAD) is a leading cause of mortality in the U.S.
  • Hyperlipidemia is a major modifiable risk factor for CAD.
  • Established guidelines exist for hyperlipidemia management, primarily using statins and newer proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.

Purpose of the Study:

  • To systematically review and validate disparities in the utilization of hyperlipidemia therapies.
  • To assess the equitable application of statins and PCSK9 inhibitors in reducing CAD risk.

Main Methods:

  • Systematic literature search of PubMed (Medline, PubMed Central) and Google Scholar (2000-2020).
  • Inclusion/exclusion criteria applied to 322 initial search results, yielding 20 articles for analysis.
  • Quality assessment and bias risk evaluation performed on included studies.

Main Results:

  • Significant disparities were identified in hyperlipidemia treatment.
  • Non-white racial groups were less likely to receive appropriate, clinically indicated therapy.
  • Women were also less likely to receive guideline-directed hyperlipidemia management.

Conclusions:

  • This systematic review confirms inequities in hyperlipidemia treatment based on race and gender.
  • Addressing these healthcare disparities requires a comprehensive, multi-faceted strategy.
  • Equitable access to effective hyperlipidemia therapies is crucial for reducing CAD mortality.

Keywords:
access to healthcarecommunity health & primary healthcare researchhealth disparities and vulnerable populationshealthcare inequalityhyperlipidemia treatmentintensity of statin dosingpcsk9 inhibitorsstatin therapytreatment guidelineswomen’s health

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