A study driven by the Spanish Society of Cardiology (SEC) and the Spanish Society of Atherosclerosis (SEA), with the support of Daiichi Sankyo, concludes that healthcare professionals tend to overestimate the degree of LDL cholesterol control compared to the objective figures of their patients.
This conclusion stems from the findings of "Observatorio. Hacia el Objetivo 55 en Dislipemia" (Observatory. Towards Target 55 in Dyslipidemia), an observational study examining lipid profile management in routine clinical practice in Spain in individuals with low, moderate, high, and very high cardiovascular risk, presented during the Congress of the Spanish Society of Atherosclerosis (SEA 2026).
This is the second phase of the project, named Observatorio II, which involved 210 specialists from 70 healthcare areas nationwide. The analysis includes data from over 3,000 patients: 27 percent with high cardiovascular risk and 56 percent with very high risk, while 47 percent were in primary prevention and 52 percent in secondary prevention.
According to the results, doctors believed that more than half of patients with high cardiovascular risk achieved their LDL cholesterol target levels, when in reality only about a third reach the goals set by the guidelines of the European societies of cardiology and atherosclerosis.
This difference implies a gap of over 20 percent between clinical perception and the actual situation. In the very high-risk group, effective LDL-C control is around 40 percent, compared to specialists' impression that it exceeds half of the patients.
The discrepancy between what physicians believe and the measured data persists across all cardiovascular risk strata and with different lipid-lowering treatment options, such as statin monotherapy, combination with ezetimibe, PCSK9 inhibitors, and bempedoic acid.
Those responsible for the study point out that this gap could become a barrier to achieving adequate lipid control, especially in individuals with high and very high cardiovascular risk.
Improvements in Lipid Control and Regional Variability
Despite everything, the data from Observatory II show progress in the actual control of lipids compared to Observatory I. In patients with high and very high cardiovascular risk, the percentage of control has gone from 22 percent to approximately one third, and from 25 to almost 40 percent, respectively.
The study also highlights notable differences in the degree of control between autonomous communities. According to Observatory II, the best results in LDL cholesterol management are related to a more widespread use of intensive lipid-lowering therapies.
"Although we have obtained better results in LDL cholesterol control in Spain, we still have a lot of room for improvement," warned the Head of the Cardiology Department at Arnau de Vilanova Hospital, Juan Cosín Sales, who is the director of the SEC Research Agency and scientific co-director of the Observatory.
Cosín emphasizes that this data highlights the convenience of reinforcing doctors' training and raising their awareness about the relevance of adjusting the perception of LDL cholesterol control to clinical reality, in order to reduce the probability of cardiovascular events.
Cardiovascular disease continues to be the leading cause of death in Europe, and achieving the LDL cholesterol levels recommended by European guidelines is key to reducing cardiovascular risk, particularly in patients classified as high and very high risk.