{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:51:53Z","timestamp":1791550313311,"version":"4.3.4"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,8,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Because of an increasing number and complexity of treatment options for lipid\u2010lowering therapy in patients with atherosclerotic cardiovascular disease, guidelines recommend greater active involvement of patients in shared decision\u2010making. However, patients' understanding and perceptions of the benefits, risks, and treatment objectives of lipid\u2010lowering therapy are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Structured questionnaires were conducted in 5006 US outpatients with atherosclerotic cardiovascular disease and suboptimal low\u2010density lipoprotein cholesterol (LDL\u2010C) control (LDL\u2010C \u226570\u00a0mg\/dL) or on a PCSK9 (proprotein convertase subtilisin\/kexin type 9) inhibitor and in 113 physician providers as a part of the GOULD (Getting to an Improved Understanding of Low\u2010Density Lipoprotein Cholesterol and Dyslipidemia Management) Registry. Mean age of the patients was 68\u00b110\u00a0years, 60% were men, and 86% were White race. Across all patients, 63% believed heart disease was the leading cause of death in men and 46% the leading cause of death in women. Only 28% of patients thought the primary reason they were taking lipid\u2010lowering medication was to lower the risk of heart attack or stroke, 68% did not know their approximate LDL\u2010C level, and 69% did not know their LDL\u2010C goal. Patients on PCSK9 inhibitors (versus LDL\u2010C cohort), younger patients (versus age \u226565\u00a0years), and men (versus women) were somewhat more knowledgeable about their disease and its management. Most physicians (66%) felt that a lack of understanding of the importance and efficacy of statins was the primary factor contributing to nonadherence, as opposed to costs (9%) or side effects (1%). More education was the most commonly used strategy to address patient\u2010reported side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">A large proportion of patients with atherosclerotic cardiovascular disease remain unaware of their underlying atherosclerotic cardiovascular disease risk, reasons for taking lipid\u2010lowering medications, current LDL\u2010C levels, or treatment goals. These data highlight a large education gap which, if addressed, may improve shared decision\u2010making and treatment adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.org\">https:\/\/www.clinicaltrials.org<\/jats:ext-link>\n                      ; Unique identifier: NCT02993120.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.020893","type":"journal-article","created":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T05:16:50Z","timestamp":1628313410000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["What Do US Physicians and Patients Think About Lipid\u2010Lowering Therapy and Goals of Treatment? Results From the GOULD Registry"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3367-0302","authenticated-orcid":false,"given":"Suzanne V.","family":"Arnold","sequence":"first","affiliation":[{"name":"Saint Luke's Mid America Heart Institute and University of Missouri\u2010Kansas City Kansas City MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research Boston MA"},{"name":"Division of Cardiovascular Medicine Brigham and Women's HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2211-7261","authenticated-orcid":false,"given":"James A.","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Texas Southwestern Medical Center Dallas TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Rosenson","sequence":"additional","affiliation":[{"name":"The Cardiometabolic Disorders Unit Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-1730","authenticated-orcid":false,"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine and Center for Cardiovascular Disease Prevention Methodist DeBakey Heart and Vascular Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4995-832X","authenticated-orcid":false,"given":"Yuyin","family":"Liu","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shushama","family":"Alam","sequence":"additional","affiliation":[{"name":"Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine E.","family":"Mues","sequence":"additional","affiliation":[{"name":"Amgen Inc Thousand Oaks CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-6245","authenticated-orcid":false,"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Brigham and Women's HospitalHarvard Medical School Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3750-9789","authenticated-orcid":false,"given":"Mikhail","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute and University of Missouri\u2010Kansas City Kansas City MO"},{"name":"The George Institute for Global Health Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the GOULD Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31357-5"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1615664"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1801174"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437738.63853.7a"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw272"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.10.014"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-303640"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198601000-00007"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000086678"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.9.6.506"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318287cf2f"},{"key":"e_1_3_1_16_2","unstructured":"Cleveland Clinic Survey: most Americans don\u2019t know heart disease is leading cause of death in women. January 30 2020. Available at: https:\/\/newsroom.clevelandclinic.org\/2020\/01\/30\/cleveland\u2010clinic\u2010survey\u2010most\u2010americans\u2010dont\u2010know\u2010heart\u2010disease\u2010is\u2010leading\u2010cause\u2010of\u2010death\u2010in\u2010women\/. Accessed March 29 2020."},{"key":"e_1_3_1_17_2","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"4","author":"Stacey D","year":"2017","unstructured":"Stacey D, L\u00e9gar\u00e9 F, Lewis K, Barry MJ, Bennett CL, Eden KB, Holmes\u2010Rovner M, Llewellyn\u2010Thomas H, Lyddiatt A, Thomson R, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2017;4:CD001431. DOI: 10.1002\/14651858.CD001431.pub5.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.04.045"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00460-7"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.22.2775"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020893","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:05:02Z","timestamp":1715583902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,17]]},"references-count":19,"journal-issue":{"issue":"16","published-print":{"date-parts":[[2021,8,17]]}},"alternative-id":["10.1161\/JAHA.120.020893"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020893","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,17]]},"assertion":[{"value":"2021-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020893"}}