Challenges in Improving Adherence to Diet and Drug Treatment in Hypercholesterolemia Patients

Abstract

Poor adherence to chronic disease treatment may seriously compromise the effectiveness of therapy, characterizing itself as a critical element for the population’s health, both from the point of view of quality of life and health economics. The causes of low adherence are many and can depend on the patient, the physician and the healthcare system. Low adherence to dietary recommendations and lipid-lowering drug therapy for hypercholesterolemia is a widespread phenomenon that may strongly limit the great advantages of serum lipid reduction strategies in primary and secondary cardiovascular prevention. Many patients discontinue treatment, and adherence decreases with time. Increasing therapeutic adherence can have a much greater impact on the health of the population than any other therapeutic advance. There are numerous strategies to increase therapy adherence according to behavior change theories. They concern the doctor and the patient. Some must be implemented at the time of prescription, others later during the follow-up. The active role of the patient in the therapeutic decision and the shared definition of LDL cholesterol targets are of paramount importance. The aim of this narrative review is to summarize evidence on current levels of adherence to lipid-lowering strategies, the causes of the lack of adequate adherence and possible physician-applicable strategies to improve it.

Function of proprotein convertase subtilisin/kexin type 9 and its role in central nervous system diseases: An update on clinical evidence

“…Hypercholesterolemia is characterized by elevated serum LDL-C levels and a significantly increased risk of coronary heart disease (Baratta et al, 2023). Under physiological conditions, LDL-C binds to the LDLR receptor on the surface of liver cells and enters the liver cells, while LDL-C is degraded in the intracellular lysosome, and LDLR is recycled back to the cell membrane.…”

“…Hypercholesterolemia is an important cause of atherosclerosis, and lowering cholesterol is a preventive strategy. Low‐density lipoprotein cholesterol (LDL‐C) is the main driving factor for the formation, occurrence and development of atherosclerosis, which level is related to cardiovascular risk in a dose‐dependent manner (Baratta et al, 2023). Drugs targeting the regulation of LDL‐C, such as hydroxymethylglutaryl Coenzyme A (HMG‐CoA) reductase inhibitors and cholesterol absorption inhibitors, have been used clinically for many years, but their effectiveness is limited or some patients are intolerant (El Hussein et al, 2023).…”