Keywords: LDL-C, Triglycerides, siRNA, icosapent ethyl, bempedoic acid, statins, ezetimibe, inclisiran
Background:
The rise in premature cardiovascular disease (CVD) death rate, associated with deprivation, is a concerning trend. However, the NHS England Long-Term Plan offers hope. It presents a proactive population health management approach to keep people healthy and prevent illness. This includes the early detection and treatment of high-risk conditions, such as raised cholesterol. The plan's focus on population health is a strategy to improve health while reducing health inequalities. This is particularly crucial in rural areas where access to secondary care may be limited. A recent European study revealed that only 33% of patients managed to reach LDL-C goals with lipid-lowering therapy, and a staggering 80% of very high-risk patients were unable to achieve the goals of statins alone. In England, data indicates that approximately three-quarters of patients with cardiovascular disease have LDL-C levels above 1.8 mmol/L.
Here, we review our approach to CVD risk reduction using medications available in primary care.
Aim of the case report:
We describe the implementation of CVD risk reduction with medications in our rural population. This is achieved through the following steps:
- Education and empowerment of the primary care
- The use of automated searches
- Addressing other CV risks and providing optimal management
- Communication with & education of patients
Case report:
Using a retrospective case series analysis, we present the results of deploying lipid-lowering therapies to optimally reduce LDL-C levels to meet targets while addressing residual risk factors identified via raised triglyceride levels. We review the utility of inclisiran, bempedoic acid, and icosapent ethyl.
Conclusions:
A proactive approach using guidance improves patients’ lipid management. Automated searches enable rapid identification of patients and using existing IT systems reduces work burden. Using all team members allows rapid assessment and optimisation of care.
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