High total serum cholesterol, medication coverage and therapeutic control: an analysis of national health examination survey data from eight countries

Roth, Gregory A.; Fihn, Stephan D.; Mokdad, Ali H.; Aekplakorn, Wichai; Hasegawa, Toshihiko; Lim, Stephen S

doi:10.2471/blt.10.079947

Cited by 116 publications

(104 citation statements)

References 31 publications

(31 reference statements)

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“…World-wide over 18 million people have died of cardiovascular disease in 2005. WHO has identified high total cholesterol as a major contributing risk factor which is modifiable and thereby could potentially reduce the incidence of cardiovascular disease (Rodgers et al, 2004;Roth et al, 2011 (Badimon et al, 2010). The protective effects of dietary flavonol intake against coronary heart disease mortality in humans was highlighted in a meta-analysis (Huxley & Neil, 2003), indicating a 20% lower risk in individuals with the highest consumption of dietary flavonols.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Antidiabetic Potential of an Aqueous Extract of Honeybush (Cyclopia intermedia) in Streptozotocin and Obese Insulin Resistant Wistar Rats

J.F.¹,

Joubert²,

Gabuza³

et al. 2011

Phytochemicals - Bioactivities and Impact on Health

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Section: Discussionmentioning

confidence: 99%

Assessment of the Antidiabetic Potential of an Aqueous Extract of Honeybush (Cyclopia intermedia) in Streptozotocin and Obese Insulin Resistant Wistar Rats

J.F.¹,

Joubert²,

Gabuza³

et al. 2011

Phytochemicals - Bioactivities and Impact on Health

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“…An elevated level of low-density lipoprotein cholesterol (LDL-C) has been established as one of the most important modifiable risk factors for cardiovascular disease (CVD) [1,2], a medical condition that is the leading reason for hospitalisation in Bulgaria and accounts for nearly two-thirds of all-cause mortality [3]. If fatal, a CVD event shortens a person’s life by an estimated 17 years [4].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of evolocumab in treatment of heterozygous familial hypercholesterolaemia in Bulgaria: measuring health benefit by effectively treated patient-years*

Borissov¹,

Urbich

Georgieva³

et al. 2017

Journal of Market Access & Health Policy

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Background: An elevated level of low-density lipoprotein cholesterol (LDL-C) constitutes one of the most important modifiable risk factors for cardiovascular disease (CVD). Individuals with heterozygous familial hypercholesterolaemia (HeFH) are particularly vulnerable to CVD events. The addition of evolocumab to statins has shown marked reductions in LDL-C levels. The objective of this analysis is to demonstrate the clinical and economic value of LDL-C lowering with evolocumab from the Bulgarian public health care perspective. Methods: A disease-specific measure of health benefit was devised: Effectively treated patient-years (ETPYs) combine length of life with the likelihood of attaining best-practice recommendations on LDL-C lowering. “Effective treatment” was defined as a reduction in LDL-C levels of ≥50%. A Markov cohort state-transition model was adapted, considering a life-long treatment duration. Demographics, baseline characteristics and efficacy data were taken from the RUTHERFORD-2 trial. The model uses the relationship between LDL-C lowering and reduced CVD event rates observed in the meta-analyses conducted by the Cholesterol Treatment Trialists’ Collaboration. Outcomes and costs (from year 2015) were discounted at an annual rate of 5%. Sensitivity analyses were conducted to assess uncertainty surrounding the results. Results: The total incremental costs of evolocumab added to statins versus statins alone are BGN 120,329 while adding 9.30 ETPYs over lifetime. These results imply an incremental cost per ETPY of BGN 12,937 (US$ 7,215; € 6,604). The use of evolocumab is associated with a relative reduction in the CVD event rate by 38% (18% per 1 mmol/L). Conclusions: Adding evolocumab to statins may be considered cost-effective in light of an additional expense per patient-year gained in which individuals with HeFH receive effective treatment under the terms of international prevention guidelines. ETPYs are an intuitive and clinically meaningful measure of patient benefit that, in relation to costs, can support health care decision-making that considers quality of care.

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“…Thus, comparative information -as is already available for diabetes and hypercholesterolaemia -is needed to benchmark and compare how health systems perform in controlling hypertension. 23,24 Our aim was to provide comparable, comprehensive and consistent evidence on the management of hypertension internationally by analysing data from health surveys in 20 countries that included blood pressure measurement.…”

Section: Introductionmentioning

confidence: 99%

Control of hypertension with medication: a comparative analysis of national surveys in 20 countries

Ikeda

Sapienza

Guerrero

et al. 2013

Bull. World Health Organ.

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138

103

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High blood pressure, also known as hypertension, is a major contributor to the global disease burden and was responsible for 7% of all disability-adjusted life years in 2010.1 Moreover, the number of people with uncontrolled hypertension has increased to around 1 billion worldwide in the past three decades.2 As a result, the effective control of hypertension has become a priority for global health policy and, with growing interest in the prevention and control of noncommunicable diseases (NCDs),3 it is vital that health-care systems deliver appropriate interventions for tackling high blood pressure

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High total serum cholesterol, medication coverage and therapeutic control: an analysis of national health examination survey data from eight countries

Cited by 116 publications

References 31 publications

Assessment of the Antidiabetic Potential of an Aqueous Extract of Honeybush (Cyclopia intermedia) in Streptozotocin and Obese Insulin Resistant Wistar Rats

Assessment of the Antidiabetic Potential of an Aqueous Extract of Honeybush (Cyclopia intermedia) in Streptozotocin and Obese Insulin Resistant Wistar Rats

Cost-effectiveness of evolocumab in treatment of heterozygous familial hypercholesterolaemia in Bulgaria: measuring health benefit by effectively treated patient-years*

Control of hypertension with medication: a comparative analysis of national surveys in 20 countries

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