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动脉样性心血管疾病的脂质管理在美国卫生系统中的变化

Nishant P Shah¹, Eric D Peterson², Peter Shrader³

¹Duke University School of Medicine, Durham, NC (N.P.S., S.S.).

Circulation. Population health and outcomes

|February 20, 2026

概括

卫生系统实施了脂质管理资源,但人口层面的有效性仍然不清楚. 目前的策略并没有显著改善动脉样硬化心血管疾病患者的低密度脂蛋白胆固醇 (LDL-C) 控制.

科学领域:

心血管医学心血管医学
医疗保健服务研究医疗服务研究

背景情况:

卫生系统已经引入了资源,以加强动脉样硬化心血管疾病 (ASCVD) 患者的脂质管理.
这些用于ASCVD脂质管理的实施资源在人口层面的有效性尚未得到充分证实.

研究的目的:

评估卫生系统级脂质管理计划在ASCVD患者中实现低密度脂蛋白胆固醇 (LDL-C) 目标方面的有效性.
确定脂质管理资源与ASCVD患者的他类药物/非他类药物治疗摄入量之间的关联.

主要方法:

分析了来自16个美国学术卫生系统的170多万ASCVD患者的电子健康记录数据 (2021-2023).
对卫生系统的调查,以确定脂质管理计划 (诊所,EHR工具,算法).
多变量逻辑回归用于评估脂质管理计划/治疗使用与达到LDL-C <70 mg/dL之间的关联.

主要成果:

只有42.5%的可用LDL-C水平的患者达到70mg/dL以下的目标.
在脂质诊所,电子健康记录工具或管理算法与实现LDL-C目标之间没有发现显著的关联.
高强度他类药物或非他类药物治疗的系统水平使用与改善的LDL-C控制无关.

结论:

尽管有各种资源和治疗方法,但许多卫生系统未能在ASCVD患者中达到LDL-C<70 mg/dL的目标.
在各个系统中观察到低吸收的降脂疗法.
创新的实施策略对于改善ASCVD的系统级脂质管理至关重要.

关键词:

血压血压血压血压心血管疾病心血管疾病胆固醇,LDL 胆固醇,LDL 胆固醇,LDL 胆固醇,LDL 胆固醇电子健康记录是电子医疗记录.脂质脂质脂质是一种

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