Presentation (CTI)

OBJECTIVES: Guideline adherence to low-density lipoprotein cholesterol (LDL-C) levels is crucial to cardiovascular management. This research aims to examine population level trends in LDL-C levels among MA beneficiaries over 10 years (2015-2024) and assess patterns by demographic subgroups. Prior research has shown improvements in LDL-C control in the US from increased statin use and available treatments. However, data on more recent population LDL-C trends remain limited, particularly within Medicare Advantage (MA) populations with unique care coordination and quality incentive structures.
METHODS: We conducted a retrospective analysis of laboratory data and insurance records for MA beneficiaries aged 65-89 years. Annual mean LDL-C values and proportion of annual LDL-C tests meeting guideline-recommended targets (<100mg/dL) were calculated. Trends will be evaluated using generalized estimating equations applying linear (mean LDL-C) and linear probability (proportion achieved <100mg/dL) models, risk-adjusting for age, sex, race, dual eligibility, number of annual LDL-C tests, and length of prior MA enrollment. Analyses will be stratified by sex, race, and dual eligibility status.
RESULTS: The study included 5,288,039 beneficiaries with ≥1 annual LDL-C measurement and 64,085,424 LDL-C tests. From 2015 to 2024, overall mean LDL-C declined 7.7% (100.1mg/dL to 92.4mg/dL), with similar declines among females (6.6%; 104.7mg/dL to 97.9mg/dL) and males (8.4%; 93.1mg/dL to 85.2mg/dL). The proportion achieving <100mg/dL increased from 54.6% to 63.1% overall; rising from 49.4% to 57.5% among females and 62.6% to 70.5% among males. Trends in both mean LDL-C and proportion achieving <100mg/dL showed continuous and consistent improvement throughout. Results will be risk-adjusted and stratified by demographic subgroups for the conference.
CONCLUSIONS: Unadjusted results indicate that LDL-C control among MA beneficiaries continued to improve over the past decade, reflecting better medication options, adherence, and preventive care. These findings highlight the value of recent innovations in LDL-C management and need for ongoing work to ensure continued progress in LDL-C control.