HealthDay News — Many young adults with moderate or severe hypercholesterolemia do not achieve guideline-directed low-density lipoprotein cholesterol (LDL-C) reduction, according to a research letter published online November 15 in JAMA Cardiology to coincide with the American Heart Association Scientific Sessions 2021, held virtually from November 13 to 15.

Shauna L. Newton, MD, from Massachusetts General Hospital in Boston, and colleagues used clinical registry data to identify 2 cohorts of adults age 20 to 39 years at the time of a qualifying LDL-C value between 2005 and 2018. A total of 17,591 individuals met the inclusion criteria: Cohort 1 included individuals with an LDL-C value of 190 mg/dL or greater (5438 participants), while cohort 2 included those with an LDL-C value of 160 to less than 190 mg/dL (12,513 individuals).

The researchers found that 30.1% of individuals in cohort 1 achieved at least a 50% reduction in LDL-C during a median follow-up of 7.8 years, with a lower likelihood of achieving this reduction in LDL-C for younger individuals. Overall, 23.4% of patients had a last LDL-C value of 190 mg/dL or greater. Lipid-lowering therapy (LLT) was prescribed to 48.5% of individuals, including 77.5 and 36.0%, respectively, of those who did and did not achieve a reduction of at least 50% in LDL-C. In cohort 2, 36.1% of individuals achieved at least a 30% reduction in LDL-C during a median 7.7 years of follow-up; 30.4% had a last LDL-C value of 160 mg/dL or greater. Only 20.0% received LLT.

“Our findings suggest significant underrecognition of the risks associated with persistent moderate hypercholesterolemia in young adulthood,” the authors write.


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One author disclosed financial ties to the pharmaceutical and technology industries.

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