Cardiovascular disease (CVD) remains a leading cause of mortality in Spain, with dyslipidaemia being a major modifiable risk factor. Lipid-lowering therapy (LLT) is essential for cardiovascular risk reduction, but regional disparities in prescription patterns and low-density lipoprotein cholesterol (LDL-C) control persist. This retrospective observational study analysed LLT prescription trends for primary prevention in Spain from 2019 to 2023, using the Spanish Primary Care Clinical Database (BDCAP), which contains anonymised records from 4.8 million individuals. Data were stratified by sex, age, community size, and employment status.
In 2023, 5.8 million individuals received LLT for primary prevention (139.6 per 1,000). Treatment rates were higher in women than in men after age 60, and highest among retirees and those living in small communities. The use of combination therapies nearly doubled over the study period, resulting in better LDL-C control (56.4% achieving LDL-C <100 mg/dL with combination therapy vs. 41.5% with monotherapy, p < 0.001). Regional disparities were notable, with the lowest treatment rates in Catalonia and the Basque Country and the highest in Galicia.1
Temporal analysis showed a gradual increase in LLT prescriptions and defined daily doses (DDD) per 1,000 individuals per day, reflecting intensified therapeutic strategies. Socioeconomic factors, such as employment status and municipality size, significantly influenced treatment rates. The study highlights the importance of addressing socioeconomic and regional disparities to ensure equitable and effective dyslipidaemia treatment. The increasing use of combination therapies suggests a shift towards more intensive lipid management, aligning with recommendations for stricter LDL-C targets in high-risk populations.1
Limitations include the lack of data on lifestyle interventions, medication adherence, and individual cardiovascular risk profiles, which may affect the interpretation of prescribing patterns. Nonetheless, this study provides valuable insights into the current state of dyslipidaemia management in Spain and underscores the need for targeted interventions and standardised clinical guidelines to improve cardiovascular risk reduction nationwide.