Patients Understand Importance of Managing Cholesterol, but Express Confusion About How

People with high cholesterol, a known risk factor for heart disease and stroke, aren’t sure how to manage their condition. A recent survey from the American Heart Association (AHA), found that 47% of people who had a history of cardiovascular disease (CVD) or stroke had not checked their cholesterol in the past year. While people with high cholesterol were more likely to have recently gotten tested, 21% still had not had their cholesterol checked in a year.

The survey was part of AHA’s new initiative Check.Change.Control.Cholesterol, which aims to help people better understand and manage their overall risk for CVD and how it relates to cholesterol. Respondents had either a history of CVD or at least 1 major CVD risk factor, such as high blood pressure, high cholesterol, or diabetes.

The purpose of the survey was to establish patient awareness of cholesterol as a risk factor for CVD and stroke, to understand patient knowledge of treatment and management, and to determine information needs and gaps.

“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 statement. “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 study found that people with a history of CVD or stroke or who have at least 1 risk factor did not fully understand their real medical risk. Only 27% thought they were at a high risk for CVD or stroke.

People with high cholesterol were mostly recommended medication (79%) as a treatment, followed by exercise (78%), and diet modifications (70%). While a large majority (89%) of people with high cholesterol said they understood the importance of cholesterol management, nearly half were not confident about their ability to do so. They felt they had sufficient information about managing their cholesterol, but were not well informed about the specifics, such as their target body weight, goals for cholesterol management, and differences between low-density lipoprotein and high-density lipoprotein.

“Research suggests even modestly elevated cholesterol levels can lead to heart disease later in life, but these survey results show an alarming lack of communication between healthcare providers and those most at risk for cardiovascular disease,” Bauman said. “Current guidelines call for lifestyle modifications as a first line treatment, but that’s often not enough. We also need to talk to patients about other risk factors, including genetics and family history, to determine the most effective course of treatment for each individual.”