A research letter published online by JAMA Cardiology points out that statin therapy is recommended for all adults 21 years or older with an LDL-C level of 190 mg/dL or greater to reduce the risk of death and save healthcare dollars.

That is not occurring, however, according to the study led by University Hospital Cleveland Medical Center researchers. Their review found that fewer than 45% of adults younger than 40 are prescribed the cholesterol-lowering medications.

The analysis was based on a national clinical registry that includes data from inpatient and outpatient encounters from 360 medical centers in all 50 states, as well as all patients between ages 20 and 75 years who had both LDL-C and pharmacy records reported between July 1, 2013, and July 31, 2016.

The focus was on the 2,884,260 patients with a qualifying lipid analysis, 3.8% of whom had an LDL-C level of 190 mg/dL or greater. Overall, results indicate that the statin-prescription rate for patients with severe dyslipidemia but without diabetes or established atherosclerotic cardiovascular disease (ASCVD) was 66%.

Age was a factor, however: Statins were prescribed in only 32%, 47%, and 61% of patients in their 30s, 40s, and 50s, respectively.

In addition, statins weren’t universally prescribed for everyone who needed them at any age. Study authors note that, even with more severe elevations in LDL-C levels (LDL-C >250 mg/dL and LDL-C >300 mg/dL), 25% of patients were not prescribed a statin.

“This finding has particular relevance given the early onset of ASCVD and cardiovascular death observed in familial hypercholesterolemia studies from the pre-statin era,” researchers conclude. “Specific interventions that optimize the follow-up of younger patients after lipid screening may be needed to realize the potential for improved survival and cost reduction associated with the treatment of severe dyslipidemia.”

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