By Jonathan Springston, Editor, Relias-AHC Media

Although the awareness of the dangers of elevated cholesterol remains high among many Americans, somehow, many at-risk individuals are not taking medication to control elevated cholesterol levels, according to a recent report.

Investigators studied data from the 1999-2014 National Health and Nutrition Examination Survey to estimate prevalence rates of self-reported screening, awareness, and statin therapy among U.S. adults 20 years of age and older with severely elevated LDL (190 mg/dL or higher). The researchers also studied a subgroup of patients with familial hypercholesterolemia. Investigators found that cholesterol screening and awareness among these patients was at 80%, but only 38% were taking cholesterol-lowering medication. Of this group, only 30% had even been prescribed a high-intensity statin.

The researchers attributed the gap between awareness and treatment to factors such as no insurance and young age.

“Young adults may be less likely to think that they are at risk of cardiovascular disease, and clinicians may be less likely to initiate statin therapy in this population,” wrote lead author Emily Bucholz, MD, PhD, MPH, department of medicine at Boston Children’s Hospital. “It is possible that lifestyle modifications continue to be prescribed as an initial treatment prior to initiating statin therapy.”

Meanwhile, the CDC recently published a report that connects noisy jobs to high blood pressure and cholesterol. Using data from the 2014 National Health Interview Study, researchers estimated the prevalence of noise exposure, heart conditions, and hearing difficulty among Americans while trying to determine a connection between noisy environments and heart disease.

“A significant percentage of the workers we studied have hearing difficulty, high blood pressure, and high cholesterol that could be attributed to noise at work,” said study co-author Liz Masterson, PhD. “If noise could be reduced to safer levels in the workplace, more than 5 million cases of hearing difficulty among noise-exposed workers could potentially be prevented. This study provides further evidence of an association of occupational noise exposure with high blood pressure and high cholesterol, and the potential to prevent these conditions if noise is reduced. It is important that workers be screened regularly for these conditions in the workplace or through a healthcare provider, so interventions can occur. As these conditions are more common among noise-exposed workers, they could especially benefit from these screenings.”

In the upcoming April 15 issue of Internal Medicine Alert, David Fiore, MD, writes about an examination of the data from the much-publicized Systolic Blood Pressure Intervention Trial (SPRINT) in which the author found no benefit of statin therapy for primary prevention of cardiovascular or all-cause mortality.

“We know that cardiovascular events increase as one ages and that statins can lower the risk of these events. What we don’t know is when the harm of another medication outweighs the benefits. Furthermore, there seem to be some elderly patients who, despite their elevated lipids, remain free of cardiac disease,” Fiore writes. “Therefore, a rational approach may be to 1) use caution when starting statin therapy for primary prevention in the elderly (especially those > 75 years of age), 2) consider stopping statin therapy in the very elderly if they have never experienced a cardiac event, and 3) consider using a calcium score to determine whether to continue statin therapy for primary prevention in those between 65 and 79 years of age, although this approach is not based on study data.”

For even more on the latest news and research in cardiology, be sure to check out new issues of Clinical Cardiology Alert as well as STEMI Watch 2018: Advances in Diagnosis, Treatment, and Management.