A recent study led by Dr. Leandro Slipczuk MD, PhD, FACC, has revealed significant differences in mortality risks among patients with severe hypercholesterolemia, characterized by LDL cholesterol levels of 190 mg/dL or higher. The study, which focused on a racially and ethnically diverse patient cohort, analyzed data from 18,740 patients treated between 2010 and 2020. The findings indicate that not all patients with severe hypercholesterolemia face the same mortality risk, with factors such as race, comorbidities and the use of lipid-lowering therapy (LLT) playing crucial roles.

The research uncovered that a significant portion of patients with severe hypercholesterolemia were not receiving adequate treatment. About 25% of patients were not prescribed statin therapy and in over half of the patients, LDL cholesterol levels remained above 130 mg/dL. The study identified several factors independently associated with increased mortality risk, including higher LDL-C levels, low HDL-C, older age, male sex, hypertension, diabetes, heart failure, myocardial infarction and lower BMI. Conversely, the use of LLT was found to decrease mortality risk. The study also noted a worrying trend of decreasing statin use over time, both in primary and secondary cardiovascular prevention. These findings emphasize the need for early recognition and consistent treatment of severe hypercholesterolemia, along with prioritizing the treatment of comorbidities to reduce overall mortality risk.