Clinical Edge

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Screening and Statin Treatment in Patients with FH

Circulation; ePub 2018 Mar 26; Bucholz, et al

Despite the high prevalence of cholesterol screening and awareness, only ≈50% of US adults with familial hypercholesterolemia (FH) are on statin therapy, with even fewer prescribed a high-intensity statin. Researchers used data from the 1999 to 2014 National Health and Nutrition Examination Survey to estimate prevalence rates of self-reported screening, awareness, and statin therapy among US adults (n=42,471 weighted to represent 212 million US adults) with FH and with severe dyslipidemia (defined as low-density lipoprotein cholesterol [LDL-C] levels ≥190 mg/dL). They found:

  • The frequency of cholesterol screening and awareness was high (>80%) among adults with definite/probable FH or severe dyslipidemia.
  • However, statin use was uniformly low (52.3%) in adults with definite/probable FH and 37.6% in adults with severe dyslipidemia.
  • Only 30.3% of patients with definite/probable FH on statins were taking a high-intensity statin.
  • Young and uninsured patients are at the highest risk for lack of screening and for undertreatment.


Bucholz EM, Rodday AM, Kolor K, Khoury MJ, de Ferranti SD. Prevalence and predictors of cholesterol screening, awareness, and statin treatment among US adults with familiar hypercholesterolemia or other forms of severe dyslipidemia (1999-2014). [Published online ahead of print March 26, 2018]. Circulation. doi:10.1161/CIRCULATIONAHA.117.032321.