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Comprehensive cholesterol therapy favorably modifies cholesterol plaque composition, alters the normal progressive course of atherosclerosis and improves patient outcomes more than any single physician intervention.

Cardiovascular risk factors can be grouped into three: non-modifiable, like age and sex, patient modifiable, like smoking and lack of exercise and physician modifiable, like high LDL cholesterol and high blood pressure.

All modifiable risk factors should be optimized for maximum heart attack and stroke protection. All are important but there is no single intervention that can match statins in their ability to reduce all cardiovascular events and supported by extensive scientific data from many large clinical trials in both primary and secondary prevention settings.

 

 

Steno Diabetes Center in Copenhagen, an international research and teaching center for diabetes, conducted a long term eight year clinical trial on patients with diabetes and albuminuria but without heart disease. One half received targeted, intensive, multifactorial risk factor therapies and the other half received conventional treatment. At the end of the trial, the targeted intensive group had more 50% event reduction. Further analysis showed the lipid therapy accounted for more than 70% of the cardiovascular risk reduction. Optimal lipid therapy is the foundation of heart disease and stroke prevention in high risk patients. This is also what we experienced in our practice after aggressive lipid therapy was implemented in 2001.

 

Overcoming the wide treatment gap in clinical practice was our priority. Using PaKS, we were able to treat most high risk patients to treatment goals. More patients at goal means lower cardiovascular risk.

 

 

There is a direct relationship between the level of cardiovascular risk and the utilization of healthcare resources. The higher the risk, the greater the utilization of expensive healthcare resources. The lowest risk has the lowest utilization. Incentivizing employees at high risk like Jim by offering proven therapies that shifts them to a lower risk category will reduce the consumption of expensive cardiovascular healthcare resources. Evidence-based preventive medical therapy of high and very high risk population can significantly reduce cardiovascular risk and the need for stents, heart bypass surgeries, cardiac hospitalizations, etc... in addition to reducing death and disability from heart attack and stroke.