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

Salim S Virani; Karen Aspry; Dave L Dixon; Keith C Ferdinand; Paul A Heidenreich; Elizabeth J Jackson; Terry A Jacobson; Janice L McAlister; David R Neff; Martha Gulati; Christie M Ballantyne

doi:10.1016/j.jacl.2023.02.003

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

J Clin Lipidol. 2023 Mar-Apr;17(2):208-218. doi: 10.1016/j.jacl.2023.02.003. Epub 2023 Feb 27.

Authors

Affiliations

¹ Baylor College of Medicine, Houston, Texas, USA (Drs Virani, Ballantyne); Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA (Dr Virani); The Aga Khan University, Karachi, Pakistan (Dr Virani).
² Lifespan Cardiovascular Institute, and Alpert Medical School, Brown University, Providence, Rhode Island, USA (Dr Aspry).
³ Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA (Dr Dixon).
⁴ Tulane University School of Medicine, New Orleans, Louisiana, USA (Dr Ferdinand).
⁵ Stanford University, Palo Alto, California, USA (Dr Heidenreich).
⁶ CardioTexas, Austin, Texas, USA (Ms Jackson).
⁷ Emory University School of Medicine, Atlanta, Georgia, USA (Dr Jacobson).
⁸ Piedmont Heart Institute, Atlanta, Georgia, USA (Dr McAlister).
⁹ Michigan State University, College of Osteopathic Medicine, Department of Family and Community Medicine, East Lansing, Michigan, USA (Dr Neff).
¹⁰ Smidt Cedars-Sinai Heart Institute, Los Angeles, California, USA (Dr Gulati).
¹¹ Baylor College of Medicine, Houston, Texas, USA (Drs Virani, Ballantyne). Electronic address: cmb@bcm.edu.

PMID: 36965958
DOI: 10.1016/j.jacl.2023.02.003

Abstract

Despite the established role of low-density lipoprotein cholesterol (LDL-C) as a major risk factor for cardiovascular disease (CVD), and the persistence of CVD as the leading cause of morbidity and mortality in the United States, national quality assurance metrics no longer include LDL-C measurement as a required performance metric. This clinical perspective reviews the history of LDL-C as a quality and performance metric and the events that led to its replacement. It also presents patient, healthcare provider, and health system rationales for re-establishing LDL-C measurement as a performance measure to improve cholesterol control in high-risk groups and to stem the rising tide of CVD morbidity and mortality, cardiovascular care disparities, and related healthcare costs.

Keywords: Blood pressure; Cardiovascular disease; LDL Cholesterol; Lipoprotein modifying; Risk factors; Statins.

MeSH terms

Cardiology*
Cardiovascular Diseases* / prevention & control
Cholesterol
Cholesterol, LDL
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors*
Risk Factors
United States / epidemiology

Substances

Cholesterol, LDL
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cholesterol