What question did this study set out to answer?

Evaluate cardiovascular risk management and lipid therapy in ulcerative colitis patients in rural settings.

January 23, 2026

P0388Missed Opportunities in Cardiovascular Prevention for Patients with Ulcerative Colitis: Insights from Routine Primary-Care Reviews in Rural General Practice

CDC DeaneyLourdes University VEV EllisLourdes University SKS KoliandrisLourdes University

Key Points

Evaluate cardiovascular risk management and lipid therapy in ulcerative colitis patients in rural settings.
Retrospective review of ulcerative colitis patients in a rural primary care practice.
Assessment of demographic factors, QRISK scores, and lipid management approaches.
Quantitative analysis of cholesterol levels pre- and post-treatment and qualitative review of documentation practices.
Mean QRISK score was 21.7%, with 66.7% classified as high risk.
Only 39.7% received statin therapy, indicating under-treatment.
LDL-cholesterol levels decreased from 3.37 to 1.69 mmol/L, but only partially met target reductions.

Abstract

Abstract Background Ulcerative colitis (UC) is increasingly recognised as an independent risk factor for atherosclerotic cardiovascular disease (ASCVD), mediated in part by chronic systemic inflammation1,2. However, ASCVD risk assessment 34 men, 29 women), all self-described as White British; 56(88.9%) were in primary 42/63(66.7%) had QRISK ≥10%, 30/63(47.6%) ≥20%, 10(15.9%) were prescribed bempedoic acid, 10(15.9%) ezetimibe, 6(9.5%) icosapent ethyl, 1.8 mmol/L but remained above the very-high-risk goal of 1.4 mmol/L3. Conclusion Despite a high burden of ASCVD risk, fewer than half of this rural UC cohort were receiving statin therapy, with more advanced agents used in a minority. Marked missingness in follow-up LDL-C suggests real-world challenges in sustained monitoring. Patterns of stepped-intensity therapy indicate clinician awareness of elevated risk but potential under-treatment relative to contemporary ESC targets. Rural UC patients exhibit substantial ASCVD risk with incomplete uptake & monitoring of lipid-lowering therapy. Embedding systematic CVD risk assessment, guideline-directed LDL-C targets and structured follow-up into UC care pathways may help mitigate excess cardiovascular burden in this population. References: 1. Cainzos-Achirica, M., et al. (2020). Inflammatory bowel disease and atherosclerotic cardiovascular diseases. Journal of the American College of Cardiology, 76(24), 2895–2905. 2. Chen, B., et al. (2022). Inflammatory bowel disease and cardiovascular disease. The American Journal of Medicine, 135(10), 1184–1194. 3. Visseren, F. L. J., et al. (2021). 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 42(34), 3227–3337. Conflict of interest: Dr. Deaney, Carl: Non-promotional grant from Ferring Ellis, Victoria: Non-promotional grant from Ferring Koliandris, Stephanie: Non-promotional grant from Ferring Donaldson, Meredith: Non-promotional grant from Ferring Meskauskiene, Agne: Non-promotional grant from Ferring.

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