AHA: Lipid-Lowering Therapy Lacking in At-Risk Populations

Even people with diabetes and moderate and high Framingham risk scores not getting therapy
By Jeff Muise
HealthDay Reporter

MONDAY, April 27 (HealthDay News) -- Some 44.9 percent of U.S. adults aged 35 and older who have an indication for lipid-lowering treatment are not receiving therapy, including some with diabetes or high cardiovascular risk, according to a poster presentation at the American Heart Association's Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference held April 23 to 25 in Washington, D.C.

Erica S. Spatz, M.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues, assembled data on 777 adults (≥35 years) from the 2003-2004 National Health and Nutrition Examination Survey, who had at least one clinical indication for lipid-lowering medications. The group included subsets of individuals who were either being treated (55.1 percent), or not being treated despite the indication (44.9 percent). The researchers used multivariate logistic regression analysis to identify access-to-care, clinical, social or demographic factors associated with not being treated.

Factors associated with not being treated included: lack of a regular source of health care (odds ratio, 3.69), age younger than 50 years (OR, 2.76), lack of insurance (OR, 2.35) and female sex (OR, 1.98). Other correlates with lack of treatment were: individuals with untreated or undiagnosed diabetes (OR, 6.73), and moderate or high Framingham risk scores (OR, 3.82 and OR, 3.22, respectively), the researchers report.

"Paradoxically, individuals with greater risk factors for cardiovascular disease were significantly less likely to receive lipid-lowering therapy. Greater efforts are needed to deliver evidence-based care," the authors write.

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