PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Study examines cost-effectiveness of newer cholesterol guidelines

2015-07-14
(Press-News.org) A microsimulation model-based analyses suggests that the health benefits associated with the 10-year atherosclerotic cardiovascular disease risk threshold of 7.5 percent or higher used in the 2013 ACC-AHA cholesterol guidelines are worth the additional costs required to achieve these health gains, and that a more lenient threshold might also be cost-effective, according to a study in the July 14 issue of JAMA.

In November 2013 the American College of Cardiology and the American Heart Association (ACC/AHA) released new recommendations to guide statin treatment initiation for the primary prevention of cardiovascular disease. These guidelines established 4 categories for statin treatment eligibility for adults 40 to 75 years of age, including 10-year atherosclerotic cardiovascular disease (ASCVD) risk of 7.5 percent or higher. It has been estimated that based on the new ASCVD risk threshold that 8.2 million additional adults in the U.S. would be recommended for statin treatment compared with previous recommendations. This expansion of statin treatment eligibility has been controversial, with some critics arguing that the guidelines substantially overestimate risk, and when taken in conjunction with more lenient treatment thresholds, millions of adults in the U.S. would be exposed to unnecessary statin treatment costs and risks, according to background information in the article.

Ankur Pandya, Ph.D., of the Harvard T.H. Chan School of Public Health, Boston, and colleagues performed a cost-effectiveness analysis of the ACC/AHA cholesterol treatment guidelines. With use of a microsimulation model, hypothetical individuals from a representative U.S. population 40 to 75 years of age received statin treatment, experienced ASCVD events, and died from ASCVD-related or non-ASCVD-related causes based on ASCVD natural history and statin treatment parameters. Data sources for model parameters included National Health and Nutrition Examination Surveys, large clinical trials and meta-analyses for statin benefits and treatment, and other published sources.

The researchers found that the current ASCVD threshold of 7.5 percent or higher, which was estimated to be associated with 48 percent of adults treated with statins, had an incremental cost-effectiveness ratio (ICER) of $37,000/quality-adjusted life-year (QALY) compared with a 10 percent or higher threshold. More lenient ASCVD thresholds of 4.0 percent or higher (61 percent of adults treated) and 3.0 percent or higher (67 percent of adults treated) had ICERs of $81,000/QALY and $140,000/QALY, respectively.

Shifting from the 7.5 percent or higher threshold to 3.0 percent or higher to 4.0 percent or higher was associated with an estimated additional 125,000 to 160,000 CVD events averted.

The optimal ASCVD threshold was sensitive to patient preferences for taking a pill daily, changes to statin price, and the risk of statin-induced diabetes.

"The decision to initiate statin treatment for adults without CVD should ultimately be informed by both evidence-based policies and patient preferences," the authors write. (doi:10.1001/jama.2015.6822; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: This work is supported by a grant to the Harvard School of Public Health from the National Heart, Lung, and Blood Institute (Dr. Gaziano). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.

Please Note: A podcast interview on this study will be available at JAMA.com at the embargo time.

Editorial: Cholesterol Lowering in 2015

"Based on available evidence, including the 2 reports in this issue of JAMA, answers to the questions of in whom and how regarding cholesterol lowering are now more clear than they were just 18 months ago," write Philip Greenland, M.D., of the Northwestern University Feinberg School of Medicine, Chicago, and Senior Editor, JAMA, and Michael S. Lauer, M.D., of the National Heart, Lung, and Blood Institute, Bethesda, Md., in an accompanying editorial.

"Available evidence indicates that statins are both effective and cost-effective for primary prevention even among low-risk individuals. Although lifestyle interventions must be employed across all segments of the population, for many people a statin drug will also be required to minimize risk. Where to set the treatment threshold and how to determine the individual's level of risk are also becoming progressively clarified."

"There is no longer any question as to whether to offer treatment with statins for patients for primary prevention, and there should now be fewer questions about how to treat and in whom. Rather, the next phase of research should be directed at better ways of applying lifestyle and drug treatments to the millions, and possibly billions, worldwide who could potentially benefit from a cost-effective approach to primary prevention of ASCVD." (doi:10.1001/jama.2015.7434; Available pre-embargo to the media at http://media.jamanetwork.com)

Editor's Note: Please see the article for additional information, including financial disclosures, funding and support, etc.

INFORMATION:



ELSE PRESS RELEASES FROM THIS DATE:

Drug provides improvement for diabetic kidney disease patients with high potassium levels

2015-07-14
Among patients with diabetic kidney disease and hyperkalemia (elevated potassium levels in the blood), a potentially life-threatening condition, those who received the new drug patiromer, twice daily for four weeks, had significant decreases in potassium levels which lasted through one year, according to a study in the July 14 issue of JAMA. Patients at the highest risk for hyperkalemia are those taking renin-angiotensin-aldosterone system (RAAS) inhibitors with stage 3 or greater chronic kidney disease (CKD) who also have diabetes mellitus, heart failure, or both. Because ...

Few states require HPV vaccine

2015-07-14
An examination of state vaccination requirements for adolescents finds that the human papillomavirus (HPV) vaccine is currently required in only two states, many fewer than another vaccine associated with sexual transmission (hepatitis B) and another primarily recommended for adolescents (meningococcal conjugate), according to a study in the July 14 issue of JAMA. Eight years after HPV vaccines were first recommended in the United States, vaccination coverage is substantially below the Healthy People 2020 target of 80 percent. Data from the U.S. Centers for Disease Control ...

Researchers create model of early human heart development from stem cells

Researchers create model of early human heart development from stem cells
2015-07-14
Berkeley -- Researchers at the University of California, Berkeley, in collaboration with scientists at the Gladstone Institutes, have developed a template for growing beating cardiac tissue from stem cells, creating a system that could serve as a model for early heart development and a drug-screening tool to make pregnancies safer. In experiments to be published Tuesday, July 14, in the journal Nature Communications, the researchers used biochemical and biophysical cues to prompt stem cells to differentiate and self-organize into micron-scale cardiac tissue, including ...

Treating more adults with statins would be cost-effective way to boost heart health

2015-07-14
Boston, MA - A new study from Harvard T.H. Chan School of Public Health researchers has found that it would be cost-effective to treat 48-67% of all adults aged 40-75 in the U.S. with cholesterol-lowering statins. By expanding the current recommended treatment guidelines and boosting the percentage of adults taking statins, an additional 161,560 cardiovascular-related events could be averted, according to the researchers. "The new cholesterol treatment guidelines have been controversial, so our goal for this study was to use the best available evidence to quantify the ...

Multiple, co-existing groups of gut bacteria keep Clostridium difficile infections at bay

2015-07-14
WASHINGTON, DC --July 14, 2015--Multiple species of bacteria working together in healthy guts are responsible for keeping out nasty bacterial invader, Clostridium difficile, a hospital-acquired culprit responsible for 15,000 deaths each year. The study, published this week in mBio, the online open-access journal of the American Society for Microbiology, could lead to tests to predict which hospital patients are at highest risk of infection and better management of infections. "Hospital-acquired C. difficile infections have bloomed as a problem in the last 10-15 years, ...

This is your brain on fried eggs

2015-07-14
High-fat feeding can cause impairments in the functioning of the mesolimbic dopamine system, says Stephanie Fulton of the University of Montreal and the CHUM Research Centre (CRCHUM.) This system is a critical brain pathway controlling motivation. Fulton's findings, published today in Neuropsychopharmacology, may have great health implications. "Our research shows that independent of weight gain and obesity, high-fat feeding can cause impairments in the functioning of the brain circuitry profoundly implicated in mood disorders, drug addiction, and overeating - several states ...

New classification system for brain tumors

2015-07-14
Despite modern chemoradiation therapy it is still very difficult to give reliable prognoses for malignant gliomas. Surgical removal of the glioma is still the preferred method of treatment. Doctors at Universitätsklinikum Erlangen's Department of Neurosurgery have now developed a new procedure for analysing radiological imaging scans which makes it possible to predict the course of a disease relatively precisely. Their findings have now been published in the journal 'Scientific Reports'.* The Friedlein Grading A/B (FGA/B) classification system - named after the physician ...

Rice U research sheds light on Amazon vs. Wal-Mart competition

2015-07-14
HOUSTON - (July 14, 2015) - After Amazon announced plans last week for a day of online retail discounts July 15 comparable to Black Friday, Wal-Mart is launching a rival sale online the same day. Who will win the e-commerce battle? Winning is a matter of consistent superior e-service quality -- not just on one particular day of the year, according to new research from Rice University's Jones Graduate School of Business. "Increased e-service quality is associated with increased customer satisfaction, which then leads to higher repurchase intentions," said Vikas Mittal, ...

Stem cell transplant alleviates symptoms in lupus animal models

2015-07-14
Putnam Valley, NY. (July 14, 2015) - Systemic lupus erythematosus (SLE) is an autoimmune disease that produces autoantibodies and subsequent immune reactions that can lead to a variety of symptoms, including inflammation of the kidneys, or nephritis. When researchers transplanted mesenchymal stem cells (MSCs) derived from human bone marrow into mice modeled with SLE, they found that inflammation was reduced and nephritis "attenuated." They suggested that their study revealed a "novel mechanism" by which the MSCs can regulate the progression of autoimmune diseases such as ...

UTHealth research: Teen birth, mental health lead child hospitalizations in Texas

2015-07-14
HOUSTON - (July 14, 2015) - From 2004 to 2010 in Texas, mental illness was the most common reason for the hospitalization of children ages 10-14 while pregnancy/birth was the most common reason for the hospitalization of adolescents ages 15-17, according to researchers at The University of Texas Health Science Center at Houston (UTHealth) Medical School. The results were published in the July issue of Hospital Pediatrics, a journal of the American Academy of Pediatrics. "We were surprised by those two findings and the related costs in millions of dollars," said Bethanie ...

LAST 30 PRESS RELEASES:

Public confidence in U.S. health agencies slides, fueled by declines among Democrats

“Quantum squeezing” a nanoscale particle for the first time

El Niño spurs extreme daily rain events despite drier monsoons in India

Two studies explore the genomic diversity of deadly mosquito vectors

Zebra finches categorize their vocal calls by meaning

Analysis challenges conventional wisdom about partisan support for US science funding

New model can accurately predict a forest’s future

‘Like talking on the telephone’: Quantum computing engineers get atoms chatting long distance

Genomic evolution of major malaria-transmitting mosquito species uncovered

Overcoming the barriers of hydrogen storage with a low-temperature hydrogen battery

Tuberculosis vulnerability of people with HIV: a viral protein implicated

Partnership with Kenya's Turkana community helps scientists discover genes involved in adaptation to desert living

Decoding the selfish gene, from evolutionary cheaters to disease control

Major review highlights latest evidence on real-time test for blood – clotting in childbirth emergencies

Inspired by bacteria’s defense strategies

Research spotlight: Combination therapy shows promise for overcoming treatment resistance in glioblastoma

University of Houston co-leads $25 million NIH-funded grant to study the delay of nearsightedness in children

NRG Oncology PREDICT-RT study completes patient accrual, tests individualized concurrent therapy and radiation for high-risk prostate cancer

Taking aim at nearsightedness in kids before it’s diagnosed

With no prior training, dogs can infer how similar types of toys work, even when they don’t look alike

Three deadliest risk factors of a common liver disease identified in new study

Dogs can extend word meanings to new objects based on function, not appearance

Palaeontology: South American amber deposit ‘abuzz’ with ancient insects

Oral microbes linked to increased risk of pancreatic cancer

Soccer heading does most damage to brain area critical for cognition

US faces rising death toll from wildfire smoke, study finds

Scenario projections of COVID-19 burden in the US, 2024-2025

Disparities by race and ethnicity in percutaneous coronary intervention

Glioblastoma cells “unstick” from their neighbors to become more deadly

Oral bacterial and fungal microbiome and subsequent risk for pancreatic cancer

[Press-News.org] Study examines cost-effectiveness of newer cholesterol guidelines