Gaps in Lipid Management of Young Adults With Elevated LDL-C Levels

Background: More than 50% of young adults have elevated low-density lipoprotein cholesterol (LDL-C) levels. This is a causal factor for atherosclerotic cardiovascular disease (ASCVD). LDL-C levels of ≥100 mg/dL in young adulthood are associated with increased risk for ASCVD, independent of exposures later in life. However, they are less likely than older adults to be screened or treated, despite guidelines recommendations. Objective: To examine patterns of LDL-C testing and statin initiation following an initial elevated LDL-C measurement, and to assess related temporal trends from 2008 to 2018. Design: Large-scale longitudinal analysis. Methods: Data were obtained from the Kaiser Permanente Southern California system. Patients aged 18 to 39 years with ≥1 elevated LDL-C measurement (≥100 mg/dL) from January 2008 to December 2020 were included. Demographic and clinical (including laboratory and prescription fill) data were collected. The primary outcome was LDL-C testing and more...