Adults with cardiovascular disease or risk factors often don’t get cholesterol checked

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Nearly half of adults with a history of cardiovascular disease or at least one major cardiovascular disease risk factor did not have their cholesterol checked within the past year, according to an American Heart Association (AHA) survey.

The survey, released April 10, was part of an AHA initiative aimed at educating patients and providers about how to manage cardiovascular disease risk.

Of the 800 people who completed the survey, 47 percent had not had their cholesterol checked within the past year, including 21 percent who had high cholesterol.

All of the respondents had a history of an MI, stroke or another cardiovascular disease or a major cardiovascular disease risk factor such as high blood pressure, high cholesterol or diabetes.

“We wanted to get a sense of what people know about their cholesterol risk and its connection to heart disease and stroke, as well as how people engage with their healthcare providers to manage their risks,” Mary Ann Bauman, MD, a member of the AHA’s cholesterol advisory group, said in a news release. “We found even among those people at the highest risk for heart disease and stroke, overall knowledge was lacking and there was a major disconnect between perceptions about cholesterol and the significance of its health impact.”

The survey found that 82 percent of respondents identified a link between cholesterol and risk for heart disease and stroke, although people with a history of cardiovascular disease had lower perceptions of their cardiovascular disease risk. In addition, only 29 percent of patients with a history of cardiovascular disease knew they were at high risk for another cardiovascular disease event.

Patients with high cholesterol most often received medications (79 percent) or were told to exercise (78 percent) or modify their diet (70 percent). Participants also said they were most likely to speak about their cholesterol with primary care providers, who were also the most likely to diagnose high cholesterol.

Sanofi and Regeneron Pharmaceuticals sponsored the initiative and the survey. The companies manufacture and market alirocumab (Praluent), an injectable cholesterol-lowering medication that the FDA approved in July 2015. The drug was the first commercially available proprotein convertase subtilisin kexin type 9 inhibitor.

So far, sales of alirocumab have not been as high as analysts and investors expected, at least in part due to the medication’s high cost. The wholesale acquisition cost of alirocumab is $40 per day for the 75 mg and 150 mg doses or nearly $15,000 per year, although the costs to payers and patients are lower. In 2016, sales of alirocumab were $116.3 million, including $94.4 million in the U.S. and $21.9 million outside the U.S.

In addition, a federal judge in Delaware ruled in January that Sanofi and Regeneron could not market or sell alirocumab in the U.S. In February, an appeals court granted a temporary stay of that ruling, which allowed the companies to continue to market, sell and distribute alirocumab during the appeals process.