Prevention & lipids

Secular Trends in Lipid Management Among U.S. Veterans With Atherosclerotic Cardiovascular Disease, 2003 to 2020

JACC AdvPublished retrospective cohort study

Authors' conclusion

We observed a clear trend toward higher prevalence of LDL-C control among Veterans with ASCVD from 2003 to 2020. Despite this progress, most Veterans remain above guideline-recommended LDL-C targets, underscoring the need for continued optimization of lipid-lowering therapy.

Study context

Population
U.S. Veterans with prevalent atherosclerotic cardiovascular disease (ASCVD) who had at least 1 low-density lipoprotein cholesterol (LDL-C) lab value in the year before January 1st of the index yearcohort grew from 642,082 in 2003 to 1.18 million in 2020 · 2003 642,082 · 2020 1.18 million
Exposure
Annual trends in the proportion of Veterans with ASCVD who achieved an LDL-C <70 mg/dL while taking lipid-lowering agents, 2003 to 2020
Outcome
LDL-C >70 mg/dL at baseline
Follow-up
Baseline
Methodological detailsannual accounting of treatment information and LDL-C lab results from 2003 to 2020
  • Annual accounting of treatment information and LDL-C lab results from 2003 to 2020

Main finding

As reported in the abstract

Veterans with LDL-C >70 mg/dL (up to)

85.4%

Observational data: associations, not effects.

Further findings

Proportion achieving LDL-C <70 mg/dL · Over the 17-year period

Start of period
14.5%
End of period
41.6%

Subgroups, including Veterans >75 years

Observations consistent across subgroups; Veterans >75 years experienced marked increases in LDL-C improvement

Original publication

Secular Trends in Lipid Management Among U.S. Veterans With Atherosclerotic Cardiovascular Disease, 2003 to 2020. JACC Adv. Published 15 July 2026. doi:10.1016/j.jacadv.2026.103004

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