# Statinen verlagen LDL-C in de dagpraktijk, maar richtlijntargets blijven vaak onbereikt

*geplaatst 2026-09-24 · Cholesterol · Scandinavian journal of primary health care · doi 10.1080/02813432.2026.2718269 · https://hartvaat.nl/2026/12/01/statinen-verlagen-ldl-c-in-de-dagpraktijk-maar-richtlijntargets-blijven-vaak-onb/*

Een cohortstudie met 507 primairzorgpatiënten met hypertensie, CAD of diabetes toont dat LDL-C over 36 maanden significant daalt bij intensivering van de statinetherapie, met een gemiddelde daling van 0,76 mmol/L (-21%) in de groep met de hoogste baseline-waarden. Ondanks de toegenomen voorschrijfgewoonte van atorvastatine en rosuvastatine blijft er een aanzienlijke kloof tussen de gehanteerde richtlijntargets en de daadwerkelijk bereikte LDL-C-niveaus. Dit real-world inzicht benadrukt de uitdagingen bij het optimaliseren van de lipidendaling in de dagelijkse zorg en onderstreept de noodzaak van intensievere risicomanagementstrategieën.

## English: Changes in LDL-C levels among primary health care patients with hypertension, coronary artery disease, and diabetes during a 36-month follow-up.

A 36-month observational study of 507 primary care patients with hypertension, coronary artery disease, or diabetes demonstrates that LDL-C levels significantly decrease with intensified statin therapy, yielding a mean reduction of 0.76 mmol/L (–21%) in patients with the highest baseline values. Despite increased prescribing of atorvastatin and rosuvastatin, a substantial gap persists between guideline-recommended LDL-C targets and real-world achieved levels. These findings highlight ongoing challenges in optimizing lipid management in everyday practice and underscore the need for more aggressive risk-reduction strategies.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) level is one important modifiable risk factor for cardiovascular diseases. This study aimed to describe the characteristics of primary health care patients with hypertension, coronary artery disease, or diabetes according to their LDL-C levels and to observe changes in these levels and medications during the 36-month follow-up. METHODS: This study was based on a clinical trial, conducted in a health centre in Siilinjärvi, Finland, between 2017 and 2021. A total of 507 patients with hypertension, coronary artery disease, or diabetes were divided into four groups based on their baseline LDL-C levels to align with the dyslipidaemia guideline risk categories as follows: LDL-C (mmol/L) in Group 0 (< 1.4), Group 1 (1.4-1.8), Group 2 (>1.8-2.6), and Group 3 (> 2.6). RESULTS: The mean age at baseline was 69 years (58% females). All patients in Groups 0 and 1 already used lipid-lowering medication. A lower LDL-C level at baseline was statistically significantly associated with higher age, lower blood pressureand lower alcohol consumption. There were changes in the pharmacologically active substances prescribed in all groups. During the 36-month follow-up, the mean LDL-C values decreased statistically significantly in group 3 (-0.76 mmol/L, 95% CI -0.90 to -0.62, -21%, p < .001: [ANCOVA]). The highest increase in lipid-lowering medication prescriptions occurred within this group. CONCLUSIONS: This study provides a perspective on real-word treatment patterns and changes in medications prescribed as the recommendations change over time. During a period of increasing pharmacotherapeutic opportunities, this study, conducted in everyday clinical practice suggests that common lipid-lowering medications (atorvastatin and rosuvastatin) are most frequently used for primary health care patients, and are associated with a significant decrease in LDL-C levels. A greater decrease was observed among patients with higher baseline LDL-C values. Despite decreases in LDL-C, this study suggests that the gap remains between guideline-recommended treatment targets and achieved LDL-C levels.

Auteurs: Petra Valkonen, Ulla Mikkonen, Hannu Kautiainen, Pekka Mäntyselkä, Nina Tusa

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Bron: Scandinavian journal of primary health care, https://doi.org/10.1080/02813432.2026.2718269. Bijgewerkt 2026-09-18T00:47:15Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.