The State of CV Disease:
A Deeper Dive


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High cholesterol is a key cardiovascular (CV) risk factor.9 Statins and a newer injectable therapy called PCSK9 inhibitors help lower high cholesterol.15,16

We’ll start with statins, since they’re currently the first-line therapy for cholesterol lowering. Statins have been around since the ‘90s and are proven to help lower LDL-C (bad cholesterol).17

Many people take statins for their heart health. but statins, along with diet and exercise, still leave persistent CV risk (P-CVR).11

If your doctor decides that your bad cholesterol needs to be even lower than what can be achieved with statin therapy, you might be prescribed a PCSK9 inhibitor.15,16 This type of LDL-C lowering therapy has been around since 2015, and in 2019, PCSK9 inhibitors were FDA-approved to reduce the risk of certain CV events.18,19

Cardiovascular (CV) disease costs lives—a lot of them. Not properly managing CV health has implications beyond your wallet.

When taking treatments without proven CV benefit (like fenofibrates, fish oil supplements, and niacin), the ultimate price tag is our health.

That cost to health increases as the untreated disease requires hospitalization and impacts our quality of life.

But there are still monetary costs involved in managing and treating any condition.
Let’s break down how much we spend in the US on CV disease per year3:


$318 billion

indirect costs (lost productivity at work and home)

$237 billion

Grand total:

$555 billion

By 2035, that shocking price tag is expected to rise to
$1.1 trillion3

Some numbers that aren’t so high? The amount spent on
CV disease research.

The National Institute of Health (NIH) invests just 4% of its budget on heart disease research, 1% on stroke research, and 2% on other CV disease research.3

We’re also making fewer medical advances for CV disease compared to other disease areas, such as cancer. In 2017, nearly 7 times more drugs were developed for cancer than for CV disease. Only 1 new CV drug was approved in 2017. Considering how many lives CV disease affects, imagine the impact every new advancement could make.20

Think cancer is the leading cause of death? Think again.

Cardiovascular (CV) disease has been the number one cause of death in the US since 1920.3

Cancer comes in second to this silent killer.2 Interestingly enough, CV disease still isn’t making headlines. Since the mid-1980s, the number of heart health-related campaigns has decreased.21

A 2018 study reviewed the New York Times coverage of the top 10 causes of death.

Of those top causes, heart disease received just 2.5% of the coverage, while cancer received 13.5%.22

Risk factors for cardiovascular (CV) disease include high cholesterol, high triglycerides, diabetes, and high blood pressure. Other factors that contribute to CV risk are: family history; prior CV events; smoking; being overweight/obese; diet and exercise.23

Heart disease is the leading cause of death for women in the US, responsible for nearly as many female as male deaths. Yet it's a common misconception that heart disease is more common in men.5

The greater your risk factors for CV disease, the greater your chance of plaque buildup.23 And as plaque builds up in your arteries (in medical speak, atherosclerosis), you’re more likely to suffer a life-threatening CV event.24

Here’s how plaque forms in 3 stages:

1Plaque buildup starts

Certain factors put us at risk for plaque buildup throughout the arteries. These risk factors can include, but are not limited to, high cholesterol, high triglycerides, diabetes, and high blood pressure.24

Over time, these risk factors injure the blood vessel lining (in medical speak, endothelial cells), causing inflammation.25

2Plaque grows

Inflammation sends out signals to start the 2nd stage: plaque growth. Plaque grows at different rates and in different arteries in the body for everyone. It’s often a slow, gradual process without symptoms you can feel.24-26

3Plaque ruptures

As plaque buildup continues, the risk of suffering a CV event increases. If plaque breaks open and ruptures, then the body will try to repair itself. However, this repair process causes blockages to form.24

When an artery becomes fully blocked, then blood flow is restricted. Blocked blood flow to the heart causes a heart attack. Blocked blood flow to the brain causes a stroke.27,28

A heart-healthy diet can help control risk factors and curb plaque growth.

Here are some foods to consider24:

  • Fruits
  • Vegetables
  • Beans
  • Whole grains
  • Lean meats
  • Poultry without skin
  • Seafood
  • Fat-free or low-fat milk and dairy products


It’s best to keep your diet low in sodium, added sugar, solid fats, and refined grains.

Triglycerides play an important role in heart health. But first, let’s start with understanding—what are triglycerides?

Triglycerides store unused calories to give your body energy and are the most common type of fat in the body. They come from foods that you eat such as butter, oils, and other fats. Your body can also make triglycerides from the extra calories that you eat such as carbohydrates, sugars, and alcohol.29,30

In higher amounts they can be harmful. In fact, if your triglycerides are even moderately elevated (>150 mg/dL), you're at greater risk for heart disease or a cardiovascular event.29 However, reducing triglycerides with medications such as fenofibrates and niacin or prescription omega-3 mixtures containing DHA has not been proven to reduce that risk when added to statins.13,31

When your triglycerides are over 500 mg/dL, you may be at higher risk for a serious condition called pancreatitis.32


You may not feel any symptoms of high triglycerides, so it’s important to see your doctor for routine blood work.

The guidelines for triglyceride levels are29:

  • Very high: 500 mg/dL and greater
  • High: 200 to 499 mg/dL
  • Borderline high: 150 to 199 mg/dL
  • Normal: less than 150 mg/dL

If your triglycerides are borderline high, you're at higher risk for cardiovascular disease. Work with your doctor on a proven plan to reduce your risk.29

What causes HIGH triglycerides?

There are many causes of high triglycerides, including29, 33:

  • Diet — What you eat and drink affects your triglyceride level, especially alcohol and processed carbohydrates
  • Lack of exercise — Not burning as many calories as you take in may have an impact on your triglycerides
  • Medical conditions — Health conditions, such as diabetes, change how your body processes food
  • Specific drugs — Drugs, including estrogen tablets and blood pressure medications
  • Genetics — People with a family history of high triglycerides may be more likely to develop them

Ask your doctor about FDA-approved therapies for CV risk reduction today.



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