Physicians' Academy for Cardiovascular Education

Minority of young adults with severe hypercholesterolemia achieve LDL-c goal

Management of Severe and Moderate Hypercholesterolemia in Young Women and Men

Literature - Newton SL, Hoffmann AP, Yu Z et al. - JAMA Cardiol. 2022 Feb 1;7(2):227-230. doi: 10.1001/jamacardio.2021.4983.

Introduction and methods


Hypercholesterolemia at a young age increases future CV risk independent of cholesterol levels at midlife and total cumulative cholesterol exposure during life [1-3]. It is therefore important to start treatment of hypercholesterolemia at a young age. ACC/AHA guidelines recommend statin therapy for individuals aged between 20 and 75 years old with LDL-c ≥190 mg/dL, with the goal of lowering LDL-c by ≥50% [4].

Aim of the study

This study investigated the management of hypercholesterolemia in two contemporary cohorts of young adults with moderate or severe hypercholesterolemia.


A total of 17591 adults aged 20 to 39 years were included in the study. Cohort 1 (n=5438) included individuals with severe hypercholesterolemia, defined as LDL-c ≥190 mg/dL, and cohort 2 (n=12513) included individuals with moderate hypercholesterolemia, defined as LDL-c 160-<190 mg/dL. Follow-up LDL-c values and prescriptions for lipid-lowering therapy (LLT) were analyzed. Median follow-up for cohort 1 and 2 was 7.8 and 7.7 years, respectively.


The primary endpoint in cohort 1 was a 50% reduction in LDL-c. In cohort 2, the primary endpoint was a 30% reduction.

Main results

1 in 3 young adults with severe hypercholesterolemia achieve a LDL-c reduction of ≥50%

Management of moderate hypercholesterolemia in young adults


This study showed that 30.1% young adults with severe hypercholesterolemia achieved a LDL-c reduction of ≥50%. In those with moderate hypercholesterolemia, 36.1% achieved a LDL-c reduction of ≥30%. Women and younger individuals were less likely to receive a prescription for LLT.


Show references

Find this article online at JAMA Cardiol.

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