Changes in LDL-C levels among primary health care patients with hypertension, coronary artery disease, and diabetes during a 36-month follow-up.

LDL-C levels decreased statistically significantly only in the highest baseline LDL-C group (Group 3, >2.6 mmol/L) during the 36-month follow-up.

• Mean LDL-C decreased by -0.76 mmol/L (95% CI -0.90 to -0.62) in Group 3
• This represented a 21% reduction (p < .001, ANCOVA)
• The highest increase in lipid-lowering medication prescriptions also occurred within Group 3
• Groups 0, 1, and 2 did not show statistically significant decreases in LDL-C

Lower baseline LDL-C levels were statistically significantly associated with higher age, lower blood pressure, and lower alcohol consumption.

• The association between baseline LDL-C group and these characteristics was statistically significant
• The study included 507 patients with a mean age of 69 years (58% female)
• Patients were divided into four groups: Group 0 (<1.4 mmol/L), Group 1 (1.4–1.8 mmol/L), Group 2 (>1.8–2.6 mmol/L), Group 3 (>2.6 mmol/L)

All patients in Groups 0 and 1 (lowest baseline LDL-C) were already using lipid-lowering medication at baseline.

• 100% of patients in Group 0 (<1.4 mmol/L) and Group 1 (1.4–1.8 mmol/L) were on lipid-lowering medication at baseline
• This indicates that patients with lower LDL-C had already been pharmacologically treated prior to the study
• There were still changes in pharmacologically active substances prescribed in all groups during follow-up

Atorvastatin and rosuvastatin were the most frequently used lipid-lowering medications in this primary health care population.

• Common lipid-lowering medications (atorvastatin and rosuvastatin) were most frequently used among primary health care patients
• These medications were associated with a significant decrease in LDL-C levels
• The study period coincided with increasing pharmacotherapeutic opportunities for lipid lowering
• Changes in pharmacologically active substances prescribed were observed in all four LDL-C groups

Despite decreases in LDL-C levels during follow-up, a gap remained between guideline-recommended treatment targets and achieved LDL-C levels.

• The study groups were defined to align with dyslipidaemia guideline risk categories
• Even Group 3, which showed the greatest reduction (-0.76 mmol/L, -21%), started above 2.6 mmol/L, well above guideline targets for high-risk patients
• The study was conducted in a real-world primary health care setting in Siilinjärvi, Finland between 2017 and 2021
• The study provides 'a perspective on real-world treatment patterns and changes in medications prescribed as the recommendations change over time'

The study population consisted of 507 primary health care patients with hypertension, coronary artery disease, or diabetes followed over 36 months.

• Mean age at baseline was 69 years; 58% were female
• The study was based on a clinical trial conducted at a health centre in Siilinjärvi, Finland between 2017 and 2021
• Patients were categorized into four LDL-C groups at baseline corresponding to dyslipidaemia guideline risk categories
• A greater decrease in LDL-C was observed among patients with higher baseline LDL-C values across all groups