Cholesterol levels in Americans are dropping and more people at especially high risk of heart disease are receiving treatment, new report show.
The findings suggest that a controversial change in cholesterol treatment recommendations may be starting to pay off, the researchers say.
"It's very exciting," he said. Dr. Pankaj Arora, cardiothoracic surgeon at the University of Alabama at Birmingham who led the new study. "But there is more to do."
Heart disease It's the world's leading killer, and high cholesterol is an essential risk factor – but it's not the only one. Doctors have long treated patients based mainly on their "bad" cholesterol level, with or without other risks.
In 2013, national guidelines asked them to focus more on people's overall heart risk, taking into account age, blood pressure, diabetes, and other factors. Those most at risk would get the most benefit from cholesterol-lowering statin drugs.
The Alabama team examined records from the Centers for Disease Control and Prevention that tracked cholesterol information from more than 32,000 adults between 2005 and 2016.
Among people taking cholesterol drugs, the average "bad" cholesterol level – known as LDL cholesterol – fell 21 points during the study period, the researchers reported. It was declining even before the 2013 guidelines, but continued to decline thereafter.
Total cholesterol levels and another type of fat known as triglycerides likewise decreased.
The results were published Monday in the Journal of American College of Cardiology.
"These are surprisingly impressive results" that together predict a 15 to 20 percent reduction in the risk of heart attacks and strokes, he said. Dr. Michael Miller, chief of preventive cardiology at the University of Maryland Medical Center, who did not participate in the study.
In addition, there was an increase in statin use by people with diabetes during the study period, from less than half to over 60% taking one of the drugs. Diabetics are particularly vulnerable to heart attacks and tend to have worse outcomes.
"It is very important that those diagnosed with diabetes do not have this first heart attack," he said. Dr. Neil J. Stone, cardiologist at Northwestern University. He led the development of the 2013 guidelines of the American College of Cardiology and American Heart Assn. And co-authored an update last year.
Arora warned that other high-risk groups had no increase in treatment – and that many people still don't know if they have a cholesterol problem.
The advice to the Americans? If you haven't had a cholesterol check recently, do one, Miller said.