Elevated cholesterol remains a major modifiable risk factor for atherosclerotic cardiovascular disease (ASCVD), yet lipid targets are unmet in many high- and very-high-risk individuals across Europe. This gap persists despite strong evidence, established guidelines, and effective therapies. To address this, the World Heart Federation (WHF) convened a Regional Europe Roundtable Series, bringing together clinicians, policymakers, researchers, and patient representatives. This review synthesises insights from meetings held in July and August 2025, alongside country case studies. Key barriers include low awareness, statin misinformation, fragmented care pathways, limited data systems, inequitable access to therapies, and inconsistent policies for familial hypercholesterolaemia detection and management. Despite these challenges, scalable solutions exist, including national strategies, screening programmes, digital referral systems, and integrated prevention initiatives. Strengthening policies, data systems, primary care capacity, public education, and equitable access to therapies will be essential to close the implementation gap in lipid management across Europe. Summary of challenges and solutions for lipid management in Europe, including unmet targets, fragmented care, limited data, and inequitable access, alongside proposed actions such as national strategies, screening programmes, digital tools, and improved therapy access.
Raspail et al. (2026) studied this question.