Key result
Baseline LDL-C above 2.6 mmol/L linked to ~0.8 mmol/L reduction with real-world statin therapy.
Why the study?
LDL-C is an important modifiable cardiovascular risk factor, but changes in LDL-C levels and medication use over time in primary care patients with hypertension, coronary artery disease, or diabetes are not well described.
How do fasting plasma LDL-C levels and lipid-lowering medication prescriptions change over a 36-month follow-up among primary health care patients with hypertension, coronary artery disease, or diabetes stratified by baseline LDL-C levels?
Cohort (n=507)
No
How do fasting plasma LDL-C levels and lipid-lowering medication prescriptions change over a 36-month follow-up among primary health care patients with hypertension, coronary artery disease, or diabetes stratified by baseline LDL-C levels?
Answers are grounded in this paper and cite their sources.
In Finnish primary care patients with hypertension, CAD, or diabetes, LDL-C levels decreased significantly over 36 months among those with the highest baseline LDL-C (>2.6 mmol/L) alongside a shift toward atorvastatin and rosuvastatin, though a substantial gap remains in achieving strict guideline LDL-C targets.
BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) level is one important modifiable risk factor for cardiovascular diseases. This study aimed to describe the characteristics of primary health care patients with hypertension, coronary artery disease, or diabetes according to their LDL-C levels and to observe changes in these levels and medications during the 36-month follow-up. METHODS: This study was based on a clinical trial, conducted in a health centre in Siilinjärvi, Finland, between 2017 and 2021. A total of 507 patients with hypertension, coronary artery disease, or diabetes were divided into four groups based on their baseline LDL-C levels to align with the dyslipidaemia guideline risk categories as follows: LDL-C (mmol/L) in Group 0 (< 1.4), Group 1 (1.4-1.8), Group 2 (>1.8-2.6), and Group 3 (> 2.6). RESULTS: < .001: [ANCOVA]). The highest increase in lipid-lowering medication prescriptions occurred within this group. CONCLUSIONS: This study provides a perspective on real-word treatment patterns and changes in medications prescribed as the recommendations change over time. During a period of increasing pharmacotherapeutic opportunities, this study, conducted in everyday clinical practice suggests that common lipid-lowering medications (atorvastatin and rosuvastatin) are most frequently used for primary health care patients, and are associated with a significant decrease in LDL-C levels. A greater decrease was observed among patients with higher baseline LDL-C values. Despite decreases in LDL-C, this study suggests that the gap remains between guideline-recommended treatment targets and achieved LDL-C levels.
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Valkonen et al. (2026) conducted a cohort in Hypertension, coronary artery disease, and/or diabetes (n=507). Baseline LDL-C risk category (>2.6 mmol/L [Group 3] and lipid-lowering medication use) vs. Lower baseline LDL-C categories (<1.4 mmol/L [Group 0], 1.4-1.8 mmol/L [Group 1], >1.8-2.6 mmol/L [Group 2]) was evaluated on Change in fasting plasma LDL-C concentration over 36 months in Group 3 (baseline LDL-C >2.6 mmol/L) (MD -0.76 mmol/L, 95% CI -0.90 to -0.62, p=0.001). Patients with baseline LDL-C >2.6 mmol/L experienced the largest LDL-C reduction of -0.76 mmol/L (95% CI -0.90 to -0.62, p=0.001) alongside increased statin prescriptions over 36 months.
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