Final Project Presentation_Davies [Autosaved]

. . Evaluation of Guideline and Trial Based Approaches for Statin Use as an Effective Primary Prevention Strategy-.

. . Outline. • Epidemiological importance of heart disease • Discuss dyslipidemia as a risk factor for cardiovascular disease • Discuss primary intervention measures • Discuss current statin use guidelines • Discuss randomized control trials • Research gap • Research project proposal to address gap • Methods & statistical analysis • Study design limitations and strengths.

. . Leading causes of death in the U.S.. Figure 4. Age-adjusted death rates for the 10 leading causes of death in 2020: United States, 2019 and 2020 Heart disease Cancer COVID-19 Unintentional injuries Stroke Chronic lower respiratory diseases Alzheimer disease DiatEtes Influenza and pneumonia Kidney disease 49.3 37.0 138.8 g 382 236.4 85.0 90 161 5 f168.2 146.2 2144.1 2019 2020 29.8 32.4 21.6 24.8 12.3 13.0 12.7 127 30 60 120 150 180 Deaths per 100,000 U.S. standard population • COVID-19 an Official cause Of death in 2020; rates for 2019 are not applicable. 'Statistically significant increase in age-adjusted death rate from 2019 to 2020 (p < 0.05). 2Statistically significant decrease in age-adjusted death rate from 2019 to 2020 (p < 005). NOTES: A total ot 3,383,729 resident deaths were registered in the united States 2020. The 10 causes of death accounted for 74.' % of all deaths in the United States 2020. Causes of death are ranked according to number of deaths. Rankings for 2019 data are not shown. Data table for Figure 4 includes the of deaths for causes and the percentage of total deaths. Access data table for Figure 4 at: httpsJ/WM.cx*cgov/nchs/dataJdatabriefs,'db427-tables.pdf#4 SOURCE: National Center for Health Statistics, National Vital Statistics System,.

. . Heart disease deaths by sex, race and ethnicity.

. . Lipoprotein profile. Total Cholesterol Level Less than 200 mg/dL 200-239 mg/dL 240 mg/dL and above LDL Cholesterol Level Less than 100 mg/dL 100-129 mg/dL 130-159 mg/dL 160-189 mg/dL 190 mg/dL and above Category Desirable Borderline high High LDL Cholesterol Category Optimal Near optimal/above optimal Borderline high High Very high *Cholesterol levels ark measured in milligrams (mg) of cholesterol per deciliter (dL) of blood..

. . Dyslipidemia. . . . Dyslipidemia. . Atherosclerosis.

. . Primary Prevention Measures. • Lifestyle modifications.

. . Impact of medications. 250 200 -0 150 8 100 50 TC HDL Non-HDL TG 1988-1994 • 1999-2Q 2007-2010 LDL Source: Data from Carroll et al. (2012). Figure 14-4. Age-Adjusted Mean Lipid and Older Profile Measure among U.S. Adults Aged 20 Years.

. . Statin use primary prevention guidelines. 1. 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines • ACC/AHA prediction model.

. . Randomized Control Trials. • JUPITER • AFCAPS • ASCOT-LLA • CARDS • MEGA • HOPE-3.

. . Which is better?. • Guideline eligibility or RCT eligibility.

. . Research Gap. • CPBS. • Homogenous source population • All participants had health insurance.

. . Project Proposal. Evaluation of Guideline and Trial Based Approaches for Statin Use as an.

. . Methods. • Source Population. • Kaiser Permanente.

. . Statistical Analysis. • examine the extent to which RCT evidence supports each of guideline-.

. . Strengths and Limitations. • unable to account for.

. . References. • Centers for Disease Control and Prevention. (2022, January 13). FASTSTATS - deaths and mortality. Centers for Disease Control and Prevention. Retrieved July 27, 2022, from https://www.cdc.gov/nchs/fastats/deaths.htm.

. . References. • Mora, & Ridker, P. M. (2006). Justification for the Use of Statins in Primary Prevention: An Intervention Trial.