According to a study published in the Journal of the American College of Cardiology, statin therapy is cost-effective for the reduction of cholesterol in young adults.
According to the study authors, these findings favor expanding preventive statin therapy to younger patients. In the present they are only qualified if they are at a high-risk of developing atherosclerotic heart disease (ASCVD).
The authors claimed that focusing on high-risk factors early in life is an innovative approach that could once again improve cardiovascular health in the U.S.
Ciaran Kohli-Lynch, PhD a postdoctoral fellow at the Center for Health Services and Outcomes Research at the Center for Education in Health Sciences (CEHS) was the lead researcher of the study. The study was co-authored by Norrina Allen (PhD) director of the Center for Epidemiology and Population Health at the Institute for Public Health and Medicine and associate professor of Preventive Medicine at the Division of Epidemiology. Bonnie Spring (PhD), chief of Behavioral Medicine in the Department of Preventive Medicine and director of the Center for Behavior and Health at IPHAM were also co-authors.
Atherosclerosis is the most significant cause of cardiovascular diseases, including heart attacks and strokes. It is caused by the buildup of fibro-fatty plaques in your arteries. LDL cholesterol plays a significant role in the development and progression of atherosclerosis.. A recent study that examined the effects of cumulative LDL cholesterol exposure in early adulthood significantly increases the risk of having a heart attack in later life.
U.S. Preventive Services Task Force guidelines recommend treatment with statins for people aged 40-75 who are at more than 10 percent risk of ASCVD. For adults younger than 40, statins are only recommended if they are at extremely high risk of ASCVD, determined by LDL cholesterol levels greater than 190mg/dl.
In the current study investigators assessed the lifetime cost-effectiveness of starting cholesterol-lowering treatments at LDL cholesterol thresholds lower than those recommended for the study group of U.S. young adults. A computer simulation model synthesized evidence regarding the LDL cholesterol-lowering effects, the side effects, treatment costs and healthcare costs associated with statin therapy as well as intensive group-based lifestyle interventions. Multiple risk factors for cardiovascular risk including cumulative LDL cholesterol levels throughout young adulthood, were used to assess the risk of future cardiovascular events.
About 26.3 million U.S. young adults — 27 percent — have an LDL cholesterol of greater than 130 mg/DL. Statin therapy for young men with high LDL cholesterol would cost $31,000 for each quality-adjusted year (QALY) achieved, while statin therapy for young adult women with LDL cholesterol >=130 mg/dL would cost $106,000 for each QALY gained. Both are considered “highly cost-effective” and “intermediately efficient,” according to the American Heart Association.
The prevalence of cardiovascular disease decreased in the second half of the 20 century as a result of the recognition of risk factors and the introduction of cholesterol-lowering drugs. However, this decrease has since stalled. According to Kohli Lynch the findings provide the beginning of a new path.
Statin use may be extended to younger adults in order to lower the risk of developing atherosclerotic heart disease. This will allow individuals to live longer and healthier lives.
Ciaran Kohli Lynch, PhD postdoctoral fellow Health Services and Outcomes Research Center for Education in Health Sciences Center (CEHS),
Kohli-Lynch, C.N., et and. (2021) Cost-Effectiveness of Lipid-Lowering Treatments for Young Adults. Journal of the American College of Cardiology. doi.org/10.1016/j.jacc.2021.08.065.
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