Prevention & lipidsResearch article

Variation in Lipid Management for Atherosclerotic Cardiovascular Disease Across US Health Systems

Circ Popul Health OutcomesPublished

  • Electronic health record data ... analyzed
  • 16 US academic health systems
  • sequential multilevel multivariable logistic regression

Authors' conclusion

Despite variability in lipid management resources and lipid-lowering therapy use across systems, many did not reach an LDL-C <70 mg/dL, and there was low uptake of lipid-lowering therapy. Innovative implementation strategies are needed for system-level lipid management.

Study context

Population
Patients with atherosclerotic cardiovascular disease across US academic health systems, January 1, 2021, to December 31, 2023patients with atherosclerotic cardiovascular disease, median, 88,365 per system, range, 17,086–2 48,371 · with an LDL-C level available 890,521
Participants
1,738,042 patients
Comparison
system-level association between an LDL-C <70 mg/dL and the presence of lipid management programs, and whether system-level uptake of statin or nonstatin lipid-lowering therapy was associated with an LDL-C <70 mg/dL

Main finding

As reported in the abstract

Health systems with prevention or lipid clinics

Health systems with prevention or lipid clinics

About 81%

Further findings

Statin use across health systems

Range
31.0% to 60.4%
Median
46.3%

Use of high-intensity statins, nonstatins, and combination lipid-lowering therapy

High-intensity statins
16.2%-33.1%
Nonstatins
2.6%-8.1%
Combination lipid-lowering therapy
1.7%-6.3%

LDL-C <70 mg/dL among those with an LDL-C level available

Among those with an LDL-C level available (n=890 521)
42.5%
Range across systems
35.8% to 49.4%

Association of LDL-C <70 mg/dL with lipid management algorithm, prevention clinics/lipid clinics, or electronic health record-based tools

No association

Association of system-level high-intensity statin utilization or nonstatin use with LDL-C <70 mg/dL

Not associated

Original publication

Variation in Lipid Management for Atherosclerotic Cardiovascular Disease Across US Health Systems. Circ Popul Health Outcomes. Published 20 February 2026. doi:10.1161/circoutcomes.125.012622

Summarised from the published abstract; every number is checked against it