While quality metrics exist for chronic conditions like hypertension and diabetes, the absence of measurement and control of low-density lipoprotein cholesterol (LDL-C) levels is conspicuous. Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of mortality, emphasizing the importance of effective LDL-C control.
Guidelines recommend lifestyle changes and high-intensity statin therapy for patients with ASCVD, with the addition of nonstatin therapy for LDL-C levels ≥70 mg/dL. However, studies indicate inadequate LDL-C control, with significant percentages of patients not taking statins or receiving high-intensity therapy. Bridging the gap between recommended and achieved LDL-C levels is crucial.
Addressing Disparities: Impact on Health Equity
Achieving optimal LDL-C control is especially important in addressing health disparities. Ethnic/racial minorities, women, and individuals with lower socioeconomic status often experience larger gaps in LDL-C control, leading to disparities in health outcomes. Re-establishing quality metrics for LDL-C measurement and control can contribute to improving health equity.
Recent evidence supports the monitoring of LDL-C levels to assess treatment response and adherence, as well as the value of add-on therapy to reach recommended LDL-C levels. Data analytics and electronic health records enable healthcare systems and providers to track LDL-C levels effectively and take prompt actions for measurement and control, ultimately improving outcomes.
Advocating for Change: The Role of the Cardiology Community
To drive meaningful change, the cardiology community must advocate for the implementation of quality metrics for lipid management, similar to those in place for blood pressure control and glycemic control. Establishing comprehensive measurement and adherence strategies for LDL-C will contribute to improving population-wide cardiovascular morbidity, mortality, and health equity.
The re-establishment of quality metrics for LDL-C measurement and control is crucial to bridge the gap between recommended and achieved LDL-C levels. By implementing comprehensive strategies, monitoring adherence, and ensuring effective treatment responses, healthcare providers can significantly improve cardiovascular health outcomes. The cardiology community plays a vital role in advocating for the integration of these quality metrics, paving the way for enhanced cardiovascular care and health equity.
