Table 1
Characteristics of study participants.
| VARIABLE | TOTAL | AUSTRALIA | BRAZIL | UNITED STATES | ||||
|---|---|---|---|---|---|---|---|---|
| n (%) | 50 | 19 | 38% | 15 | 30% | 16 | 32% | |
| ASCVD (n, %) | ||||||||
| Yes | 22 | 44% | 7 | 37% | 7 | 47% | 8 | 50% |
| No | 28 | 56% | 12 | 63% | 8 | 53% | 8 | 50% |
| Age (mean, SD) | 54.7 | 10.7 | 61.9 | 11.5 | 48.3 | 11.5 | 51.2 | 10.1 |
| Age Category (n, %) | 0% | |||||||
| Less than 45 | 12 | 24% | 2 | 11% | 7 | 47% | 3 | 19% |
| 45 to 64 | 27 | 54% | 8 | 42% | 8 | 53% | 11 | 69% |
| Over 65 | 11 | 22% | 9 | 47% | 0 | 0% | 2 | 13% |
| Sex (n, %) | 0% | 0% | 0% | |||||
| Female | 25 | 50% | 4 | 21% | 10 | 67% | 11 | 69% |
| Male | 25 | 50% | 15 | 79% | 5 | 33% | 5 | 31% |
| Marital Status (n, %) | ||||||||
| Married | 27 | 54% | 9 | 47% | 11 | 73% | 7 | 44% |
| Never Married | 14 | 28% | 8 | 42% | 2 | 13% | 4 | 25% |
| Divorced | 7 | 14% | 1 | 5% | 2 | 13% | 4 | 25% |
| Widowed | 2 | 4% | 1 | 5% | 0 | 0% | 1 | 6% |
| Smoking (n, %) | ||||||||
| Never smoked | 33 | 66% | 10 | 53% | 9 | 60% | 14 | 88% |
| Current smoker | 7 | 14% | 3 | 16% | 3 | 20% | 1 | 6% |
| Ever smoker | 10 | 20% | 6 | 32% | 3 | 20% | 1 | 6% |
| Weight (n, %) | ||||||||
| Underweight | 0 | 0% | 0 | 0% | 0 | 0% | 0 | 0% |
| Normal weight | 17 | 34% | 6 | 32% | 7 | 47% | 4 | 25% |
| Overweight | 24 | 48% | 13 | 68% | 5 | 33% | 6 | 38% |
| Obese | 9 | 18% | 0 | 0% | 3 | 20% | 6 | 38% |
| Rurality (n, %) | ||||||||
| Rural | 3 | 6% | 1 | 5% | 0 | 0% | 2 | 13% |
| Suburban | 32 | 64% | 18 | 95% | 5 | 33% | 9 | 56% |
| Urban | 15 | 30% | 0 | 0% | 10 | 67% | 5 | 31% |
| Education (n, %) | ||||||||
| Some high school | 4 | 8% | 4 | 21% | 0 | 0% | 0 | 0% |
| High school | 5 | 10% | 1 | 5% | 4 | 27% | 0 | 0% |
| Some college | 10 | 20% | 1 | 5% | 2 | 13% | 7 | 44% |
| College graduate or above | 31 | 62% | 13 | 68% | 9 | 60% | 9 | 56% |
| Event (n, %) | ||||||||
| Ischemic stroke | 5 | 10% | 0 | 0% | 2 | 13% | 3 | 19% |
| Heart attack | 14 | 28% | 4 | 21% | 5 | 33% | 5 | 31% |
| Peripheral artery disease | 7 | 14% | 3 | 16% | 2 | 13% | 2 | 13% |
| Unstable Angina | 3 | 6% | 0 | 0% | 2 | 13% | 1 | 6% |
| Comorbidity (n, %) | ||||||||
| Diabetes | 20 | 40% | 4 | 21% | 10 | 67% | 6 | 38% |
| High blood pressure | 33 | 66% | 10 | 53% | 12 | 80% | 11 | 69% |
Table 2
Summary of study findings.
| TOPIC | KEY TAKEAWAYS |
|---|---|
| Pathways to diagnosis |
|
| Understanding of LDL-C risks and treatment |
|
| Emotional impacts |
|
| Factors impacting lifestyle change |
|
| Perceptions of current therapies and desired outcomes |
|
Table 3
Example messages to improve messaging on the importance of remaining adherent to a care plan suggested by participants.
| Message Recommended by Participants | Illustrative Quotes from Interviewees |
| Share examples from real people living with high cholesterol | Participant in the United States who experienced an ASCVD event hospitalization: I would start off with the education part of lowering your cholesterol could significantly lower your chances for heart disease, heart attack. I would try to give examples of things that I have done myself and show little snippets of—or videos of me actually doing these things. And I guess trying to appeal to the sense that I’m living. Had I not been taking these medications, or if I’m not taking it correctly…what the effect of that would be. |
| Preventing a cardiac event is easier than recovering from one | Participant in the United States who experienced an ASCVD event hospitalization: Don’t wait until you’ve fallen off the cliff to try to get back up. So be careful. Be careful, because then it’s much harder to go back and try to fix it than it is to prevent it. |
| Take it seriously because the effects of not taking it seriously are physically painful | Participant in Brazil who experienced an ASCVD event hospitalization: Look, I know I felt terrible. It felt like death. So whoever can, whoever has a health plan, whatever, get yourself treated, go and get your tests done to make sure you don’t have anything, to take care of yourself because it’s very bad. It’s terrible. |
| Be blunt about risk of cardiac events | Participant in Australia who had not experienced an ASCVD event hospitalization: I think, personally, the world in general has become too afraid to be direct, do you know what I mean? I think the message doctors need to give is direct to the point and even throw a little bit of scare factor in. And come to think of it, [doctor’s name] did say it could lead on to heart disease and he did also mention about my weight. He always mentions my weight and he’s given me charts of what I should eat and what I shouldn’t. I think people just need to realize, look, if you’ve got it, take your tablets. It’s a very simple regime to do and it becomes automatic and hopefully doesn’t lead to… I don’t know. You basically really gotta be more blunt and say, Okay, if you don’t take your tablets, you’re gonna have the heart attack and you’re gonna end up with problems with your heart. So, I don’t know. It’s hard. It’s very hard to say. |
| You need to take your medicines | Participant in the United States who experienced an ASCVD event hospitalization: You just have to try and live every day the best that you possibly can. And I know that, for a lot of people, they don’t like taking meds. But they are a life-saving tool. There’s no question about it. |
| Repetition | Participant in the United States who experienced an ASCVD event hospitalization: Probably in my case, it’s effective just to hear it all the time. I can be stubborn and tend to do things at my own pace. So, I’m the kind of individual that constantly needs to hear it, probably, for it to be most effective. |