Abstract 3704: Prevalence of Lipid Disorders and Treatment Patterns in Overall and High Risk U.S. Adults with Dyslipidemia in 2003–2004
Background: Recent data on the extent of lipid disorders and treatments used among U.S. adults with dyslipidemia are limited; particularly among those with high coronary heart disease (CHD) risk. We therefore examined the prevalence of lipid disorders and utilization of lipid modifying therapies (LMT) to determine any gaps in therapy.
Methods: We identified 1,111 U.S. adults aged ≥20 years (mean age 56 years, 45% female; representing 126 million US adults) with dyslipidemia (defined as elevated LDL-C as per National Cholesterol Education Program guidelines, or being on LMT) from the National Health and Nutrition Examination Survey 2003–2004. Of these, 609 (representing 19.4 million) adults with dyslipidemia were identified as high risk (i.e. CHD, diabetes or other CHD risk equivalents). LMT included statins, fibrates, niacin, cholesterol absorption inhibitors, bile acid sequestrants, as well as combination therapies. Lipid disorders were defined according to deviation from recommended levels for LDL-C (target level defined according to updated NCEP guidelines by risk group), HDL-C (≥40mg/dL for men and ≥50mg/dL for women) and triglycerides (TG) (<200 mg/dL).
Results: Of the total population (n=1,111) with dyslipidemia, 85% remained uncontrolled for LDL-C, HDL-C, and or TG; 36% had ≥2 lipid disorders, while 42% had HDL-C and/or TG disorders with or without elevated LDL-C. Among high risk subjects, 88% remained uncontrolled on ≥1 of these lipid parameters; 36% had ≥2 lipid disorders simultaneously while 43% had HDL-C and/or TG disorders irrespective of LDL-C levels. However, only 34% (39% among high risk) were on LMT. Of those on treatment, monotherapy with statins was most common (~80%), followed by statin combination therapy (8 –10% depending on risk status).
Conclusions: Our cross-sectional assessment of US adults suggests that despite high prevalence of lipid disorders (up to 85%), LMT is utilized by <40% of subjects. Furthermore, there is a large disconnect between high prevalence of HDL and/or TG disorders, with or without elevated LDL-C, and utilization of therapies targeting these lipids (<10% of therapy utilized was non-statins), a particular concern among high risk patients.