Mary McGowan, MD: US Clinicians Missing the Mark for High-Risk Hypercholesterolemia

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Mary McGowan, MD, discusses a study she presented examining the overall prevalence of patients with high-risk hypercholesterolemia who fail to meet guideline-recommended goals for LDL-C levels.

New research from the Family Heart Foundation presented at theAmerican College of Cardiology (ACC) 2023 Annual Scientific Session Together With the World Congress of Cardiology is providing a snapshot of contemporary issues in cholesterol management in the US.

Presented by Mary McGowan, MD, chief medical officer of the Family Heart Foundation, results of the study, which included data from more than 40 million patients, suggest more than 70% of high-risk patients with hypercholesterolemia never reach the ACC guideline-recommended goal for LDL-C.1

“This study provides us with a clear view of the poor state of LDL cholesterol management for high-risk individuals in the United States,” McGowan said.2 “Despite the availability of safe and effective lipid-lowering therapies, only 28% of high-risk patients ever reach below guideline LDL-C thresholds, which further elevates these patients’ risks for atherosclerotic cardiovascular disease (ASCVD) events, such as heart attacks and stroke.”

Using the Family Heart database, which includes real-world diagnostic, procedural, and prescription data from claims and/or laboratory information in the US from 2012-2021, investigators obtained data related to a cohort containing 44 million patients considered to be high or very high risk with hypercholesterolemia. The purpose of the investigators study was to provide a comprehensive overview of hypercholesterolemia management in this patient population.1

Upon analysis, results of the study indicated just 27.8% of all high-risk patients ever reached guideline-recommended thresholds for LDL-C, with those who did achieve these thresholds maintaining these levels for a mean duration of 158.8 days despite most patients having nearly 4 years of follow-up data.Further analysis indicated 79.5% of clinicians never prescribed combination cholesterol-lowering medications and just 2.2% of high-rise patients received combination cholesterol-lowering medications during the follow-up period.1

With an interest in learning more about the contemporary state of lipid management in the US, HCPLive sat down with McGowan at ACC 2023. That conversation is the subject of the video interview found below.


  1. Wilemon K, MacDougall D, McGowan M, et al. 71% OF HIGH RISK HYPERCHOLESTEROLEMIA PATIENTS NEVER REACH ACC AHA GUIDELINES. J Am Coll Cardiol. 2023 Mar, 81 (8_Supplement) 1231.
  2. Family Heart Foundation real-world analysis reveals that majority of Americans at high risk of stroke and heart attack remain under-treated. Business Wire. Published February 28, 2023. Accessed March 6, 2023.

Mary McGowan, MD, has no relevant disclosures to report.