Trends and Factors Associated with LDL-C Treatment Target Attainment Rates among Patients with Secondary Prevention Setting of Atherosclerotic Cardiovascular Disease: Assessments from Japanese Health Checkup Data

Aims According to the latest Japanese Guidelines for the Prevention of Atherosclerotic Disease, the target for secondary prevention of low-density lipoprotein cholesterol (LDL-C) is <100 mg/dL in patients with coronary artery disease and <70 mg/dL in patients with acute coronary syndrome, familial hypercholesterolemia, diabetes, or atherothrombotic cerebral infarction. However, it is still unclear if the LDL-C treatment target attainment rates are in an upward trend and what are the factors associated with target attainment. This study aimed to investigate the trends and factors associated with LDL-C treatment target attainment. Methods Using the Health Checkup data in Kanazawa City in 2008, 2012, 2017, and 2022 (n = 38,146-51,969), we analyzed the trends of secondary prevention of LDL-C treatment target attainment rates using the Cochran-Armitage trend test and the factors associated with target attainment by a logistic regression analysis from the 2022 health examination. Results We found that the attainment rates showed a significant upward trend over time (p<0.001), and we also found that a male sex (odds ratio: 2.64, 95% CI: 1.72-4.06, p<0.001) and several lifestyle factors, such as walking or any equivalent amount of physical activity for more than one hour a day, were significantly associated with LDL-C target attainment. Conclusions The LDL-C treatment target attainment rates tended to increase over time, and several factors were associated with LDL-C target attainment.