The importance of low-density lipoprotein cholesterol measurement and control as performance measures: A joint Clinical Perspective from the National Lipid Association and the American Society for Preventive Cardiology

Prevalence, Awareness, and Treatment of Elevated LDL Cholesterol in US Adults, 1999-2020

“…This lack of awareness and treatment may be due to difficulties accessing primary care, low rates of screening in primary care, lack of consensus on screening recommendations, insufficient emphasis on LDL-C as a quality measure, and hesitance to treat asymptomatic individuals. This survey-based analysis was limited by a small number of participants with LDL-C levels of 190 mg/dL or greater, possible nonresponse bias, and dependency on participant recall of whether LDL-C was previously measured.…”

“…This lack of awareness and treatment may be due to difficulties accessing primary care, low rates of screening in primary care, lack of consensus on screening recommendations, insufficient emphasis on LDL-C as a quality measure, 6 and hesitance to treat asymptomatic individuals. This survey-based analysis was limited by a small number of participants with LDL-C levels of 190 mg/dL or greater, possible nonresponse bias, and dependency on participant recall of whether LDL-C was previously measured.…”

Groups Urge a Return to LDL-C Monitoring as a Quality Metric

“…Cholesterol monitoring and treatment to reach a goal of LDL-C below 130 mg/dL was the NCQA's performance measure for cholesterol care starting in 2000, according to the joint perspective. 1,2 The target was later updated to 100 mg/dL starting in 2010. The ACC/AHA's 2013 cholesterol guidelines recommended high intensity statin treatment rather than a "treat-to-target" goal but continued to recommend ongoing cholesterol monitoring.…”

“…he National Lipid Association (NLA) and the American Society for Preventive Cardiology (ASPC) recommend reinstating routine low-density lipoprotein cholesterol (LDL-C) monitoring as a quality metric rather than statin prescribing alone, according to a joint perspective released by the 2 organizations. 1,2 Ongoing cholesterol monitoring is recommended based on the highest tier of evidence available in the 2018 guideline on blood cholesterol management from the American College of Cardiology (ACC)/ American Heart Association (AHA) Task Force on Clinical Practice Guidelines. 3 However, the National Committee on Quality Assurance (NCQA) currently only tracks and measures whether patients were prescribed or received a moderateor high-intensity statin and were at least 80% adherent.…”

“…The National Lipid Association (NLA) and the American Society for Preventive Cardiology (ASPC) recommend reinstating routine low-density lipoprotein cholesterol (LDL-C) monitoring as a quality metric rather than statin prescribing alone, according to a joint perspective released by the 2 organizations. 1,2…”