Public health Policy, research + analysis

Confronting cholesterol: Bringing it all together to solve Australia’s ASCVD crisis

February 2025

Confronting cholesterol: Bringing it all together to solve Australia’s ASCVD crisis

Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to cardiovascular disease (CVD) burden and continues to drive significant disability and death despite well-established strategies and treatments.

1 in 20

Australians live with ASCVD.

~1 in 6

deaths in Australia attributed to ASCVD in 2022.

~271,000 hospitalisations

with ASCVD as principal diagnosis recorded in 2022.

~439, 000

disability adjusted life years (DALYs), lost to ASCVD in 2023.

Urgent action is needed. We are losing too many Australians to preventable strokes and heart attacks.

Optimising low-density-lipoprotein cholesterol (LDL-C) levels has been proven to significantly reduce risk and improve cardiovascular health outcomes. However, few Australians have their levels optimised through a regular ‘test and treat’ cycle.

~40 per cent of high-risk patients do not meet LDL-C targets.

This is despite Australia having all the pieces of the puzzle to support affordable access to critical elements of the ‘test and treat’ cycle including: subsidised diagnostics and medicines, evidenced-based patient support programs, skilled and accessible healthcare professionals, and a supportive health policy framework.

20241202.AMGEN.Confronting.Cholesterol.Design._PRINT

This undesirable and dangerous situation stems from an interaction of several factors.

Patients and their treating teams often do not understand the importance of LDL-C levels.
Care coordination across the health care system is difficult.
Policy formulation and implementation has been slow.

Combined these make an inherently treatable disease much more difficult to manage than it should be.

Australia has the resources, evidence, and strategies needed to combat ASCVD effectively – now is the time to bring these pieces together and save lives.

Australia has all the pieces of the puzzle to reduce ASCVD events and save lives, but these pieces need to be connected to form a cohesive model of care (MoC). Our report Confronting cholesterol proposes to 5 recommendations to help bring these pieces together.

AMGEN-Confronting-Cholesterol-Design-recommendations

References

Australian Institute of Health and Welfare, Heart, stroke and vascular disease: fact tables, data tables. 2024.
Silverman, M.G., et al., Association Between Lowering LDL-C and Cardiovascular Risk Reduction Among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA, 2016. 316(12): p. 1289-97.
Evohealth. Australia’s cholesterol heartache: A simple roadmap for urgent action on cholesterol management. 2020; Available from: https://www.evohealth.com.au/wp-content/uploads/2020/11/Australias-Cholesterol-Heartache_FINAL_Digital.pdf.
Carrington, M., et al. Code Red: overturning Australia’s cholesterol complacency. 2020; Available from: https://baker.edu.au/-/media/documents/impact/baker-institute_code-red-report.pdf.
Redfern, J., et al., SNAPSHOT ACS Cohort Follow-Up – What Happens to Australian Patients in the 3 Years after Hospital Discharge: A National Data Linkage Study. Heart, Lung and Circulation, 2019. 28: p. S373.
O’Donnell, M.J., et al., Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet, 2016. 388(10046): p. 761-75.
Stroke Foundation. Economic Impact of Stroke Report. 2024; Available from: https://strokefoundation.org.au/media/g2rh1imp/2024-economic-impact-of-stroke-report-final.pdf.
Australian Institute of Health and Welfare, Australia’s health 2016. Australia’s health series no. 15. Cat. no. AUS 199.
Australian Institute of Health and Welfare, National Hospital Morbidity Database (NHMD) 2021-22.
Briffa, T.G., et al., Population trends of recurrent coronary heart disease event rates remain high. Circ Cardiovasc Qual Outcomes, 2011. 4(1): p. 107-13.