Fat problem: Lowering cholesterol pays twice

The Austrians have a huge problem with their blood lipid levels. Too much cholesterol is responsible for 8.6 percent of all deaths and 28 percent of cardiovascular mortality. The annual direct and indirect costs amount to 1.166 billion euros. This was the result of a study by the Institute for Advanced Studies (IHS).

The health economists Thomas Czypionka, Miriam Reiss and Stephanie Reitzinger – supported by the pharmaceutical company Novartis – calculated the economic costs of the so-called hypercholesterolemia for Austria for the first time. Excessively high blood fat levels, especially “bad” LDL cholesterol, are the most important risk factor for vascular calcification and thus for heart attacks, strokes, etc., together with smoking and high blood pressure.

To date, there have been no representative data on hypercholesterolemia from series laboratory studies in Austria. “We had to fall back on Germany,” says Czypionka, speaking of a “shortcoming”. The experts drew conclusions from, among other things, the prescriptions of cholesterol-lowering drugs, demographic data and cause-of-death statistics.

Old population plays in statistics

In any case, the calculations of the health economists showed extremely questionable facts for Austria. While it is assumed that the proportion of high blood lipid levels as the cause of mortality is 7.7 percent worldwide, the figure in Austria is 8.6 percent. This is due to the higher average age of the Austrian population.

Good therapy options

As such, people at low risk should have less than 115 milligrams of LDL cholesterol per deciliter of blood. People with an increased to high risk (e.g. smokers, diabetics, patients with high blood pressure) should have less than 70 milligrams of LDL cholesterol in the laboratory test. On the other hand, people who are most at risk (e.g. after a first heart attack, etc.) should not have more than 55 milligrams of LDL blood lipids per deciliter. Total cholesterol should generally be less than 190 milligrams per deciliter of blood. For decades now, there have been highly effective and well-tolerated drugs for any drug therapy.

Healthy target values ​​are rarely achieved

In Austria, however, the target values ​​for total cholesterol alone are only achieved by 74 percent of 18 to 29-year-old men and 63 percent of women in this age group. For men, this proportion drops to 43 to 46 percent by the age of 80, for women it is still 57 percent among the 30 to 44 year olds, and then only well below 40 percent.

15 percent of the population at risk

This means that around 166,000 women over the age of 40 have a maximum risk of cardiovascular disease due to their hypercholesterolaemia. According to Czypionka, there are even around 172,000 men in this age group. If you add the people with a high risk, you get around 1.164 million people affected. “15 percent of the population is at high or very high risk of cardiovascular disease.”

High cost in addition to suffering

This has significant economic implications: the direct medical costs for diseases caused by hypercholesterolemia amount to 834.7 million euros per year or 2.35 percent of current health expenditure excluding long-term care. In addition, there are 28.3 million euros in direct non-medical costs (sickness benefit, nursing care, invalidity pension, etc.). The indirect costs (sick leave, disability, premature mortality, etc.) amount to 303.2 million euros per year. All in all, this adds up to 1.166.2 billion euros – including 1.6 percent of the nursing care and 4.6 percent of the disability pensions per year.

Expert warns to take countermeasures

Countermeasures – i.e. screening people for high blood lipid levels using a simple laboratory test and appropriate treatment and lifestyle changes (nutrition, exercise) – would certainly pay off, according to Czypionka: “You could save a lot of suffering and costs.” Above all, effective drug treatment of high cholesterol levels is important, because the problem can only be influenced by five to ten percent through exercise and nutrition.

Savings easily possible

According to the calculations, the Austrian economy could achieve annual cost savings of 360 million euros simply by reducing excessively high LDL cholesterol levels by 50 percent in the group of people at risk. If this were also the case for the people most at risk, it would be an additional 131 million euros.

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