Created by The Atlantic’s marketing team and paid for by Amgen with support from the Family Heart Foundation
Re:think Original / Amgen with support from the Family Heart Foundation
Illustrations by Ricardo Santos

The Heart We have the tools to combat America’s cardiovascular health crisis. Now it’s time for action. of the Matter

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Every year in the U.S., more than 800,000 people have a heart attack.

Another 800,000 have a stroke.

Both are consequences of cardiovascular disease—a group of heart and blood vessel conditions. At least 82 million Americans have one or more of these conditions.

Cardiovascular disease is often seen as the inevitable result of aging. But this is a dangerous misperception.

We have the knowledge—and the medical tools—that we need to take this urgent problem on.

Now, we need health-care practitioners, insurers, policy makers, and patients to work together to tackle it.

One of the most effective ways for patients to lower their risk of cardiovascular events is to reduce their low-density lipoprotein cholesterol—also known as LDL-C or “bad” cholesterol.

But, according to a new Family Heart Foundation analysis of 38 million Americans, more than 70 percent of people at high risk for cardiovascular disease are living with LDL-C above recommended levels.

For people considered at high risk for cardiovascular disease who can’t control their LDL-C with diet alone, there are clear clinical guidelines for addressing the problem. Here’s how it’s supposed to work:

After a cholesterol test comes back with high LDL-C, health-care practitioners prescribe treatments called “lipid-lowering therapies,” or LLTs. For decades, these statins have been the first line of defense for most people. Today, there are many therapies that work in combination with statins to dramatically lower LDL-C.

Think of treatment for pathogenic levels of LDL-C as a journey: it’s not just about hitting a one-time milestone, but maintaining a healthy number for life.


Evidence shows that lowering LDL-C by 40 mg per deciliter reduces the likelihood of a cardiac event by 20 percent.*

Using multiple therapies can help patients reach their treatment goal and maintain it.

But only 20 percent of doctors in the U.S. prescribe multiple therapies for people at risk of a cardiac event.

And only 2 percent of high-risk Americans end up receiving combination therapy.

*According to a study of statin use in patients with atherosclerotic cardiovascular disease

Katherine Wilemon

Katherine Wilemon was a healthy 39-year-old, and a new mom, when she suffered a shocking heart attack.

It turned out she had a complete blockage of one of the arteries in her heart. Katherine learned later that she had high LDL-C from birth because she had a genetic condition known as familial hypercholesterolemia, or FH.

Katherine began a therapy regimen, and made it her mission to learn as much as she could about the causes of heart disease and the options for treatment. She later decided to create the Family Heart Foundation to help change how we address cardiovascular disease for those at highest risk.

The health risks of elevated LDL-C are severe.

According to Family Heart Foundation research, people at high risk for cardiovascular disease who don’t maintain their recommended LDL-C level are 49 percent more likely to suffer a cardiac event than those who have reached their goal and maintain it over time.


And yet only 28 percent of high-risk patients ever reach their treatment goal.

Those who do typically maintain their recommended LDL-C level for less than six months at a time.

This is a failure of the entire health-care system.

How can we do better?

For one, all Americans need to find out their LDL-C level. Once they understand their cardiovascular risk, they can work with their health-care practitioner to make sure they’re protected as well as possible against disease.

Health-care practitioners, in turn, need to help everyone lower their LDL-C in accordance with clinical guidelines. That means starting with statins and adding additional therapies based on the patient’s need.

Payers have a societal responsibility to prioritize LDL-C management in the fight against cardiovascular disease. Today, too many insurance plans obstruct the best care by placing administrative burdens on health-care practitioners and economic burdens on their own members.