Simplifying the Approach to the Management of Dyslipidemia
- J. Michael Gaziano, MD, MPH;
- Thomas A. Gaziano, MD, MSc
- Author Affiliations: Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts (Dr J. M. Gaziano); Divisions of Cardiology (Drs J. M. Gaziano and T. A. Gaziano), Aging (Dr J. M. Gaziano), and Preventive Medicine (Dr J. M. Gaziano), Department of Medicine, Brigham and Women's Hospital, Boston; and Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston (Dr T. A. Gaziano). Dr J. M. Gaziano is also Contributing Editor, JAMA.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ATHEROSCLEROSIS
- CARDIOVASCULAR DISEASES
- CHOLESTEROL, LDL
- DATA INTERPRETATION, STATISTICAL
- DRUG COSTS
- DRUG THERAPY
- DYSLIPIDEMIAS
- HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS
- MASS SCREENING
- PRIMARY PREVENTION
- PUBLIC HEALTH
- RISK FACTORS
- UNITED STATES
In this issue of JAMA, Kuklina and colleagues1 report trends over the last decade in cholesterol levels and treatment. While the decreasing prevalence of “high” low-density lipoprotein cholesterol (LDL-C) levels and increasing use of lipid-lowering medications in appropriate individuals are encouraging, the most sobering message in this article is the disappointing rates of screening, awareness, and treatment. Among those with high LDL-C levels, one-third had not been screened, and one-fourth were unaware that their levels were high. About two-thirds of those who were high risk were not receiving medication, although the vast majority of these individuals would likely benefit from lipid-lowering therapy.
With a wealth of data supporting the benefit of treatment with lipid-lowering medications, why are so few persons with elevated LDL-C levels being treated? The authors speculate that one reason for these disappointing rates may be the complexity of existing guidelines. There are several sets of …
