Achievement of LDL-Cholesterol Goals in Patients Receiving LLT in Primary Care: TERESA-AP Study: LDL-Cholesterol

Sergio Cinza-Sanjurjo1,2,3,4, Vivencio Barrios5,6, David Fierro-González7

  • 1Milladoiro Health Centre Santiago de Compostela Health Area, Santiago de Compostela, Spain.

PubMed

Insights

Only 26% of patients on lipid-lowering drugs in primary care achieved their LDL-cholesterol goals. This highlights challenges in managing cardiovascular risk factors, particularly for those with chronic kidney disease.

Area of Science:

  • Cardiology
  • Primary Care Medicine
  • Pharmacotherapy

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is a critical, yet challenging, cardiovascular risk factor.
  • Stricter LDL-C goals since 2019 underscore its significance in atherosclerotic plaque development.
  • Effective management of LDL-C is vital for reducing overall cardiovascular risk.

Purpose of the Study:

  • To assess LDL-C control in patients receiving lipid-lowering drug treatment (LLT) within primary care settings.
  • To analyze the achievement of therapeutic targets in a real-world primary care population.
  • To identify factors influencing LDL-C goal attainment in treated patients.

Main Methods:

  • An observational, multicenter, cross-sectional, nationwide study.
  • Recruitment of 929 patients from 50 primary care physicians, on LLT for ≥6 months.
  • Data collection on cardiovascular risk factors and LDL-C control.

Main Results:

  • Only 26.0% of patients achieved their recommended LDL-C goals.
  • Goal attainment was higher in patients with cardiovascular disease (26.7%) and diabetes mellitus (35.5%).
  • Patients with chronic kidney disease had significantly lower goal attainment (12.1%).
  • Moderate-intensity statin monotherapy (69.0%) and statin-ezetimibe combination (27.6%) were the most common treatments.

Conclusions:

  • A significant majority of primary care patients on LLT do not reach their LDL-C therapeutic targets.
  • Specific comorbidities like CVD and DM show slightly better, but still suboptimal, control rates.
  • CKD presents a particular challenge for achieving LDL-C goals.
  • Moderate-intensity statins, alone or with ezetimibe, are the predominant treatment strategies.

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