Trends in the Management of Low-Density Lipoprotein Cholesterol in the Primary Healthcare Centre in Kaunas over the Five-Year Period

Background and Objectives: Low-density lipoprotein cholesterol (LDL-C) is a marker of cardiovascular risk and its management. This study evaluated LDL-C control trends in patients treated at a single healthcare centre in Lithuania. Materials and Methods: The study was conducted at the primary healthcare centre Saulės šeimos medicinos centras. Five-year (2019-2023) data on patients aged 40 years or older diagnosed with dyslipidaemia were extracted from a real-world data and analytics platform TriNetX. For analysis, patients were grouped into three groups: patients with dyslipidaemia only (control group), patients with dyslipidaemia and diabetes, and patients with dyslipidaemia and cardiovascular disease (CVD). The following LDL-C goals were used for analysis: < 1.4 mmol/L (a goal for very-high-risk patients in primary or secondary prevention), < 1.8 mmol/L (a goal for high-risk patients), and < 3.0 mmol/L (a goal for low-risk patients). Results: There were 18646 patients with dyslipidaemia. Of them, 8.9% of patients had diabetes and 3.1% of patients had CVD. The median LDL-C concentration was significantly lower in patients with diabetes (2.82 mmol/L, p < 0.05) and in patients with CVD (2.45 mmol/L, p < 0.05) than in the control group (3.35 mmol/L). A trend of decreasing median LDL-C over the years was observed in all groups, with the lowest median values in 2023. The proportion of patients with LDL-C level < 3 mmol/L increased from 32.0% in 2019 to 41.5% in 2023. The proportion of diabetic patients achieving LDL-C < 1.8 mmol/L increased from 7.4% to 25.9% and those achieving LDL-C < 1.4 mmol/L increased from 3.1% to 10.6%. The proportion of patients with CVD achieving LDL-C < 1.8 mmol/L increased from 14.2% to 36.6% and those achieving LDL-C < 1.4 mmol/L increased from 3.0% to 14.0%. Conclusions: Trends in the control of LDL-C levels are positive over 5 years, but a significant proportion of patients still did not reach the recommended target levels.