Social disparities in the treatment of cardiovascular diseases

Since the introduction of statins to treat high cholesterol, the decline in lipid levels experienced by the wealthy has been double that experienced by the poor. While statins are highly effective in reducing cholesterol and improving heart health, their use may have contributed to expanding social disparities in the treatment of cardiovascular disease, according to research by Virginia W. Chang, MD, PhD, of the Philadelphia Veterans Affairs Medical Center and the University of Pennsylvania, and Diane S. Lauderdale, PhD, of the University of Chicago, published in the September issue of Journal of Health and Social Behavior.

"Income disparities in lipid levels have reversed over the past three decades," according to Dr. Chang, lead author and Assistant Professor of Medicine and Sociology at the University of Pennsylvania. "High cholesterol was once known as a rich man's disease, because the wealthy had easier access to high fat foods (e.g., red meat). Now wealthy Americans are least likely to have high cholesterol, because they are more likely to be treated with statins, an expensive but highly effective pharmaceutical treatment to lower lipid levels."

While cardiovascular disease remains a leading cause of death in the U.S., mortality due to heart disease has declined dramatically since the 1980s. Researchers estimate that about one-third of that reduction is a result of pharmaceutical innovation, including the use of statins. Dr. Chang notes, "Though statins have a longer-run potential to reduce disparities by making it easier for everyone to lower cholesterol relative to lifestyle changes, they have yet to diffuse widely across all income levels."

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