Mortality from cardiovascular disease is plummeting, but heart disease is still responsible for many adverse effects on individuals and employers.
In Canada, approximately $24 billion a year is spent on treating cardiovascular disease. “It is a huge cost burden,” said Dr. James Stone, clinical professor of medicine at the University of Calgary. More and more Canadians are living with cardiovascular disease and coping with the disabilities that result—a trend that’s expected to rise even more over the next two decades.
Managing cardiovascular disease includes taking preventative steps such as quitting smoking, exercising, limiting alcohol intake (to one or two alcoholic beverages per day for men, and one per day for women) and managing cholesterol.
Elevated cholesterol levels are associated with increased risk of cardiovascular disease in general. Low-density lipoprotein (LDL), which carries cholesterol, is a marker of atherosclerosis risk. “Once you have symptomatic cardiovascular disease, the lower your cholesterol levels, the better you do,” said Stone. “Even if you don’t have symptoms, if you’re at high risk for an event and if we lower your cholesterol, you do better.”
Next-generation treatments
In Canada, statins are the current standard therapy for cardiovascular care. Coming down the line, however, are PCSK9 inhibitors (proprotein convertase subtilisin/kexin type 9), a new class of cholesterol drugs. PCSK9 inhibition helps to increase the number of LDL receptors on the liver cells, which helps lower cholesterol.
“With PCSK9 inhibitors and with statins, we can get to LDL levels of less than one: we can get back to the levels you were born with,” Stone explained. “Does it make a difference? We’re waiting for that information. Stay tuned for the future.”
Responding to an audience question on how to improve medication adherence rates, Stone emphasized communication between healthcare professionals and patients is key.
“From an employer’s perspective, it’s about getting employees engaged with healthcare professionals who will enter into a dialogue with them about a medication’s benefits and risks, and the reasons they should be on it.”
All the articles from the event can be found in our special section: 2015 Calgary Benefits Summit Coverage.
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