Arq. Bras. Cardiol. 2025; 122(7): e20240617
Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy
Andressa Braga
, Marisa Santos, Carlos Magliano
, Katia Senna, Bernardo Tura, Ione Oliveira
ABSTRACT
Background:
The 2017 Brazilian Guideline on Dyslipidemias recommends a low-density lipoprotein (LDL-c) target of <50 mg/dL for patients under secondary prevention of cardiovascular events, with statin therapy and the addition of ezetimibe if necessary. For patients who do not achieve this target, additional pharmacotherapy is indicated.
Objectives:
This study combined population data from the Brazilian Unified Health System (SUS) and the supplementary health system, epidemiological data, and the Delphi method, with participation from 29 specialists in the first round and 24 in the second, to estimate the size of the secondary prevention population not achieving LDL-c targets.
Results:
The population under secondary prevention was estimated at 5,8 million in the public health system and 1,2 million in the supplementary health system. Approximately one million patients in SUS and 150 thousand in the supplementary system are not expected to reach the LDL-c target with oral lipid-lowering therapy.
Conclusion:
Between 9% and 19% of patients under secondary prevention do not reach the recommended LDL-c target, making them potential candidates for additional LDL-c–lowering therapies.
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