Lipid Management

Over the next 12 months the South West AHSN is aiming to ensure that more patients ‘at risk’ of and with CVD are effectively treated for their cholesterol. Our support involves increasing awareness and knowledge of the national guidance for lipid management and it’s associated pathways  in both primary and secondary care. We are working collaboratively with our partners to deliver targeted education across the region to re-design and deliver improved lipid services and share best practice across the region.  

The AHSN Network Lipid Management and Familial Hypercholesterolaemia programme has a focus on optimising the treatment of disordered lipids to give patients the best chance of avoiding cardiac events. 

This page has been created to provide information to healthcare professionals about the treatment options for disordered lipids, as outlined in the Lipid Management Pathway. 

Why is Lipid Management a priority? 

Cardiovascular disease (CVD) is associated with brain, heart and vascular health risks and makes up the leading cause of death in England.

• 137,000 deaths per year of which 37,000 (26%) are premature
• 6.8 million living with CVD
• £7.4bn in costs to the NHS, and £15.8bn with the wider economy

Preventing and managing CVD and its risk factors has the potential to improve population health and ease pressures on overstretched health and care systems by reducing demand for services. 

Lipid management in England must improve to drive better CVD outcomes  

• Every 1mmol/L reduction in LDL-C is tied to a 22% reduction in major vascular events after one year
• A EU-wide study revealed that 61% of high-risk ASCVD patients are unable to reach an LDL-C goal of <1.8mmol (ESC target) signposting the need for a different approach

Lipid control is a vital part of this: 43% of all adults live with LDL-C levels above national guidelines

LDL-C management for secondary prevention is a clinical priority for patients and the NHS, as recognised by incentives in the 2023/2024 QOF amounting to 30 points and ~£36 million in funds.  

The 2023/2024 updates of QOF include a non-HDL target that is lower than 2.5 mmol/L or where non-HDL cholesterol is not recorded an LDL-C target of lower than 1.8 mmol/L for secondary prevention patients. 1 

The 1.8 mmol/L LDL-C target in the QOF may not be reachable for some patients with statins alone.4 

Many high-risk CVD patients could still benefit from further treatment optimisation and access to further combination therapies within the lipid management pathway 

Despite other successful lipid management initiatives  by the AAC and AHSNs in England, many high-risk CVD patients could still benefit from further treatment optimisation and access to further combination therapies.