From the Guidelines
High cholesterol significantly increases the risk of cardiovascular disease (CVD) events and mortality, with four out of five very high- and extremely high-risk patients not achieving their low-density lipoprotein cholesterol goal of therapy 1. The risks associated with hypercholesterolemia include:
- Increased risk of first and recurrent CVD events
- Increased risk of mortality
- Increased risk of stroke
- Increased risk of heart disease Key points to consider:
- The 2024 International Lipid Expert Panel (ILEP) recommendations suggest upfront lipid-lowering combination therapy for very high-risk secondary prevention patients 1
- Effective lipid-lowering therapy (LLT) can significantly reduce the risk of atherosclerotic cardiovascular disease (ASCVD) 1
- New agents such as bempedoic acid and monoclonal antibody/small interference RNA (siRNA) targeting proprotein convertase subtilisin/kexin type 9 (PCSK9) can reduce LDL-C levels by even > 85% and consequently reduce the risk of ASCVD 1
- Poor adherence to statin therapy is common in patients at high CVD risk and is associated with worse outcomes 1
- Higher-intensity LLT results in fewer ASCVD events than less-intensive treatment 1 The most effective way to manage high cholesterol is through a combination of lifestyle changes and medication, with a focus on reducing LDL-C levels and increasing HDL-C levels 1. Lifestyle changes include:
- Adopting a heart-healthy diet low in saturated fats and high in fiber
- Exercising regularly (at least 150 minutes of moderate activity per week)
- Maintaining a healthy weight
- Quitting smoking Medications such as statins, ezetimibe, and PCSK9 inhibitors can also be effective in reducing LDL-C levels and preventing CVD events 1.
From the FDA Drug Label
Atorvastatin calcium tablets are used: to reduce the risk of: heart attack, stroke, certain types of heart surgery and chest pain in adults who do not have heart disease but have other multiple risk factors for heart disease.
Atorvastatin calcium tablets are used: to reduce the risk of: heart attack and stroke in adults with type 2 diabetes mellitus who do not have heart disease but have other multiple risk factors
Atorvastatin calcium tablets are used: to reduce the risk of: heart attack that does not cause death, stroke, certain types of heart surgery, hospitalization for congestive heart failure, and chest pain in adults with heart disease.
The risks associated with hypercholesterolemia (high cholesterol) include:
- Heart attack
- Stroke
- Certain types of heart surgery
- Chest pain
- Hospitalization for congestive heart failure These risks can be reduced with the use of atorvastatin calcium tablets, especially in adults with multiple risk factors for coronary heart disease or those with type 2 diabetes mellitus and multiple risk factors for coronary heart disease 2, 2, 2.
From the Research
Risks Associated with Hypercholesterolemia
The risks associated with hypercholesterolemia (high cholesterol) include:
- Cardiovascular disease: Hypercholesterolemia is a major risk factor for cardiovascular disease, which can lead to heart attacks, strokes, and other cardiovascular events 3, 4, 5.
- Atherosclerosis: High cholesterol levels can lead to the formation of plaques in the arteries, which can cause atherosclerosis and increase the risk of cardiovascular disease 3, 6.
- Increased risk of mortality: Hypercholesterolemia can increase the risk of mortality from cardiovascular disease, especially in patients with other risk factors such as diabetes, hypertension, and smoking 7, 5.
Factors that Increase the Risk of Cardiovascular Disease
Several factors can increase the risk of cardiovascular disease in patients with hypercholesterolemia, including:
- High levels of low-density lipoprotein (LDL) cholesterol: LDL cholesterol is often referred to as "bad" cholesterol, and high levels can increase the risk of cardiovascular disease 4, 6, 5.
- Low levels of high-density lipoprotein (HDL) cholesterol: HDL cholesterol is often referred to as "good" cholesterol, and low levels can increase the risk of cardiovascular disease 6.
- Presence of other risk factors: Other risk factors, such as diabetes, hypertension, and smoking, can increase the risk of cardiovascular disease in patients with hypercholesterolemia 7, 5.
Management of Hypercholesterolemia
The management of hypercholesterolemia typically involves a combination of lifestyle changes and medication, including:
- Therapeutic lifestyle changes (TLC): TLC includes dietary changes, increased physical activity, and smoking cessation, and can help to reduce the risk of cardiovascular disease 7.
- Statins: Statins are a type of medication that can help to lower LDL cholesterol levels and reduce the risk of cardiovascular disease 4, 5.
- Other medications: Other medications, such as fibrates and niacin, may also be used to manage hypercholesterolemia, especially in patients who are at high risk of cardiovascular disease 4, 6, 5.