MONDAY, Aug. 3, 2026 (HealthDay News) -- There are considerable gaps in low-density lipoprotein cholesterol (LDL-C) control, especially among adults with established atherosclerotic cardiovascular disease (ASCVD), according to a research letter published online July 20 in the Journal of the American Medical Association.
Shady Abohashem, M.D., M.P.H., from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues estimated the proportion of U.S. adults whose LDL-C levels exceed 2026 guideline-recommended goals across the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT)-ASCVD risk categories and among those with established ASCVD. Data were included from adults aged 30 to 79 years from the National Health and Nutrition Examination Survey 2021 to 2023 cycle.
The analytic sample included 2,313 participants, who represented 177.7 million U.S. adults (87.8 and 12.2 percent in primary and secondary prevention cohorts, respectively). The researchers found that an estimated 32.2 percent of adults in the primary prevention cohort had LDL-C levels above guideline-recommended goals, with increasing prevalence seen across higher risk categories. The proportion above LDL-C goal was an estimated 9.9, 63.6, and 82.7 percent among PREVENT-estimated low-, borderline/intermediate-, and high-risk adults, respectively. Across groups, demographic patterns were generally similar; a higher proportion was above goal among older adults and men. Overall, an estimated 79.6 percent of those with established ASCVD had LDL-C levels above goal, with patterns similar across demographic subgroups. Of those with LDL-C above goal, an estimated 76.1 and 37.6 percent of those in primary and secondary prevention, respectively, were not receiving lipid-lowering therapy.
"The gap between where the country's cholesterol levels actually are and where the new guidelines say they should be is much wider than most people realize," Abohashem said in a statement.
Several authors disclosed ties to the biopharmaceutical and biotechnology industries.
