Prevention & lipidsCohort study
Follow-Up Lipid Testing and Statin Initiation Among Young Adults in a U.S. Health Care System
- Retrospective cohort study
Authors' conclusion
These findings suggest care gaps in lipid management of young adults with elevated LDL-C and represent missed opportunities to reduce cumulative LDL-C exposure and to prevent premature ASCVD during a critical window of vulnerability.
Study context
- Population
- Kaiser Permanente Southern California members aged 18 to 39 years with first elevated low-density lipoprotein cholesterol (LDL-C) (index) between 2008 and 2020
- Participants
- 771,681 members
- Outcome
- Proportion with follow-up LDL-C test and statin initiation after index elevated LDL-C
- Follow-up
- Within 1, 2, and 5 years
Main finding
As reported in the abstract
LDL-C ≥190 mg/dL: statin initiation within 1, 2, 5 years
28.4%, 33.5%, 45.7%
High 30-year atherosclerotic cardiovascular disease (ASCVD) risk and LDL-C 160 to 189 mg/dL: statin initiation within 1, 2, 5 years
25.3%, 31.9%, 46.4%
High 30-year ASCVD risk and LDL-C ≥190 mg/dL: statin initiation within 1, 2, 5 years
44.1%, 50.2%, 61.5%
Observational data: associations, not effects.
Further findings
Index LDL-C distribution
- LDL-C 100 to 129 / 130 to 159 / 160 to 189 / ≥190 mg/dL
- 65.9%, 25.3%, 6.9%, 1.9%
Follow-up LDL-C testing within 1 year, trend 2008 to 2018 (LDL-C 160 to 189 mg/dL and high 30-year risk)
- Declined from 2008 to 2018
- 52.5% to 35.4%
Statin initiation within 1 year, trend 2008 to 2018 (both high-risk subgroups)
- Declined from 2008 to 2018
- 31.7% and 36.5% in 2008 to 20.1% and 12.6% in 2018
Original publication
Summarised from the published abstract; every number is checked against it