An analysis of young adults with LDL-C ≥190 mg/dL found that statin therapy was initiated in less than half within five years, with a decline in follow-up testing signaling a further significant care gap.

The longitudinal study conducted from 2008 to 2020, presented at AHA 2025 and simultaneously published in JACC, centered on 771,681 young adults aged 18-39 years in the Kaiser Permanente Southern California health care system (mean age, 30 years; 51% women; 47% Hispanic).

Results showed that among participants with LDL-C levels ≥190 mg/dL, only 29%, 34% and 46% had statin therapy started within one, two and five years, respectively.

Additionally, one-year follow-up testing among participants with LDL-C levels between 160-189 mg/dL and a high 30-year risk of atherosclerotic cardiovascular disease declined from 53% to 36% from 2008 to 2018. Statin initiation in high-risk populations also declined during the same period: from 32% to 20% for those with LDL-C 160-189 mg/dL and from 37% to 13% for those with LDL-C ≥190 mg/dL.

"Our findings underscore that early adulthood is a critical window for prevention, and identifying these areas of opportunities for earlier intervention is essential to reducing young adults' lifelong heart risk," said Teresa N. Harrison, SM, a researcher at Kaiser Permanente Southern California and lead author of the study.

"The good news is that health care systems have a potential roadmap to develop next-generation care models," Harrison said. "The promising results from our safety net program, SureNet, suggest that integrating patient outreach and clinician decision support may be an effective strategy to further advance proactive, early cardiovascular prevention."

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Clinical Topics: Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins

Keywords: AHA Annual Scientific Sessions, AHA25, Delivery of Health Care, Cholesterol, LDL, Secondary Prevention