Statin treatment and LDL-cholesterol treatment goal attainment among individuals with familial hypercholesterolaemia in primary care

Iyen, Barbara; Akyea, Ralph K.; Weng, Stephen; Kai, Joe; Qureshi, Nadeem

Abstract

Objectives: Guidance recommends statin treatment in Familial Hypercholesterolaemia (FH) achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). We assessed statin prescribing rates and LDL-cholesterol treatment goal attainment among individuals with FH in primary care.

Methods: Using primary care electronic health records from the UK Clinical Practice Research Datalink (CPRD), we identified adults with recorded diagnosis of FH, statin treatment, and measures of LDL-cholesterol prior to (baseline) and 12 months after initiating statin treatment. The percentage change in LDL-cholesterol was determined, and then baseline and treatment characteristics were assessed by LDL-cholesterol treatment goal attainment.

Results: Of 3,064 adults (mean age 50.8 years) with recorded diagnosis of FH and repeat LDL-C measures, 50% reduction in LDL-cholesterol from baseline, was attained in 895 individuals (29.2%) in 12 months. Compared to those who did not attain this goal, these people were predominantly females, they were older at time of FH diagnosis (53.4 years vs 49.7 years) and first statin treatment (53.2 years vs 49.2 years); and had higher pre-treatment total cholesterol (8.20 (SD 1.38) mmol/l vs 7.57 (SD 1.39) mmol/l) and pre-treatment LDL-cholesterol (5.83 (SD 1.36) mmol vs 5.25 (SD 1.40) mmol/l). A higher proportion of individuals who attained the treatment goal were prescribed high and medium potency statins (24.3% and 71.7% versus 20.2% and 69.3%, respectively).

Conclusions: Less than a third of individuals on statin treatment for FH in the community achieve recommended reductions in LDL-cholesterol. Greater awareness and optimisation of treatment for FH using higher potency statins is needed.

• Journal Article Type: Article
• Acceptance Date: Oct 6, 2021
• Online Publication Date: Oct 26, 2021
• Publication Date: Oct 26, 2021
• Deposit Date: Oct 19, 2021
• Publicly Available Date: Oct 29, 2021
• Journal: Open Heart
• Print ISSN: 2053-3624
• Publisher: BMJ
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 2
• Article Number: e001817
• DOI: https://doi.org/10.1136/openhrt-2021-001817
• Keywords: Cardiology and Cardiovascular Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/6503447
• Publisher URL: https://openheart.bmj.com/content/8/2/e001817