Atherosclerotic Cardiovascular Disease

The causal role of LDL-cholesterol in atherosclerotic cardiovascular disease

Short animation detailing the role of LDL-cholesterol in the development of disease and the clinical sequalae associated with disease progression.

For a clinical narrative on ACLY inhibition in atherosclerotic disease review this reference.

Hear from the experts

Experts share their perspectives on “lower is better and lowest is best.”

Elevated LDL-C leads to cardiovascular disease (CVD), the number one cause of death globally. 1,2

In the US, CVD accounts for one in three deaths.1,3 One-third of deaths from CVD occur prematurely in people under 70 years of age.2

The WHO estimates heart disease deaths will increase 26% by 2030.4

Nearly 80%

of very high-risk patients did not meet a guideline-recommended LDL-C target5

8.2 million

patients with ASCVD in the U.S. don’t reach their LDL-C goals despite taking a statin6

9.6 million

patients with ASCVD in the U.S. are not on any lipid lowering therapy6

High low-density lipoprotein cholesterol (LDL-C) has been treatable for decades, but something is not working. Cardiovascular disease continues to increase. Guideline LDL-C targets are not met. Patients give up on their medicines entirely. The problem? Patients’ needs are not being met by their cholesterol medicines.
In a recently published analysis, the US prevalence of ASCVD in 2019 was estimated at > 24 million patients. The authors noted that 72.6% of subjects with ASCVD had an LDL-C greater than the national guideline recommendation of less than 70 mg/dL. In these same subjects, only one in four were on a high-intensity statin, and over 40% were not on any lipid lowering therapy.6 
Data suggest that statins cause more side effects in women than in men.4,7,8

Many patients who do everything right – the hard work of changing their diet, exercising and taking their medicine as prescribed – still don’t reach their goals.

References

  1. World Health Organization. The challenge of cardiovascular disease – quick statistics. https://www.euro.who.int/en/health-topics/noncommunicable-diseases/cardiovascular-diseases/data-and-statistics. Accessed November 30, 2020.
  2. Global Status Report on Noncommunicable Diseases 2014. Geneva, Switzerland: World Health Organization; 2014. http://apps.who.int/iris. bitstream/10665/148114/1/9789241564854_eng.pdf. Accessed January 11, 2021.
  3. Benjamin EJ, Muntner P, Alonso A, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139:00–00.
  4. Culver AL, Ockene IS, Balasubramanian R et al. Statin use and risk of diabetes mellitus in postmenopausal women in the Women’s Health Initiative. Arch. Int. Med. 172(2), 144–152
  5. Yan AT, Yan RT, Tan M, et al. Contemporary management of dyslipidemia in high-risk patients: targets still not met. Am J Med. 2006;119(8):676-683.
  6. Gu et al. Lipid treatment status and goal attainment among patients with atherosclerotic cardiovascular disease in the United states. A 2019 update. Am J Prev Cardiol. 2022 Jun; 10: 100336.
  7. Barbara H Roberts & Rita F Redberg (2013) Gender disparity in statin response: are statins less effective in women?, Clinical Lipidology, 8:2, 161-163, DOI: 10.2217/ clp.13.7.
  8. Ridker PM, Danielson E, Fonseca FA et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N. Engl. J. Med. 359, 2195–2207 (2009)