Achievement of LDL-Cholesterol Goals in Patients Receiving LLT in Primary Care: TERESA-AP Study: LDL-Cholesterol Goals in Primary Care

Cardiovasc Ther. 2024 Jul 3:2024:4227941. doi: 10.1155/2024/4227941. eCollection 2024.

Abstract

Background and Aim: Since 2019, LDL-cholesterol (LDL-C) is the risk factor with the strictest goals and the most difficult to reach, due to its role in the development of atherosclerotic plaque and, therefore, cardiovascular risk. The objective of the TERESA-AP study is to analyze the degree of LDL-C control in patients followed up in primary care with lipid-lowering drug treatment (LLT). Methods: Observational, multicenter, cross-sectional, nationwide study was conducted, in which 50 PC physicians recruited 929 patients who were receiving LLT during at least the preceding 6 months. The variables required to estimate the patients' cardiovascular risk and LDL control were recorded. Results: Nearly half of sample was women (50.5%), and the mean age was 67.8 (10.4) years. High blood pressure (65.3%) and sedentary lifestyle (59.7%) were the most frequent risk factors. Recommended goals were reached in 26.0% (95% CI: 23.3%-29.0%) of patients, with a slightly higher percentage in patients with cardiovascular disease (CVD) (26.7%), diabetes mellitus (DM) (35.5%), and a lower one in patients with chronic kidney disease (CKD) (12.1%). The most frequent drug treatments were statin monotherapy (69.0%) and statin with ezetimibe combination (27.6%), with moderate-intensity statins being the most commonly used in both groups. Conclusions: On average, only a quarter of the patients followed up in PC and who receive drug treatment reach their therapeutic targets. This percentage is slightly higher if the patients have CVD and DM and lower if they have CKD. The most commonly used therapeutic strategy is moderate-intensity statins, both in monotherapy and in combination with ezetimibe.

Keywords: LDL-cholesterol goals; cardiovascular risk; lipid-lowering therapy; primary care.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Anticholesteremic Agents / adverse effects
  • Anticholesteremic Agents / therapeutic use
  • Biomarkers* / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • Cholesterol, LDL* / blood
  • Cross-Sectional Studies
  • Dyslipidemias* / blood
  • Dyslipidemias* / diagnosis
  • Dyslipidemias* / drug therapy
  • Dyslipidemias* / epidemiology
  • Female
  • Heart Disease Risk Factors*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypolipidemic Agents / adverse effects
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Primary Health Care*
  • Risk Assessment
  • Time Factors
  • Treatment Outcome

Substances

  • Cholesterol, LDL
  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Anticholesteremic Agents