Objectives Guidance recommends statin treatment in familial hypercholesterolaemia (FH) to achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). We assessed statin prescribing rates and LDL-C treatment goal attainment among individuals with FH in primary care. Methods Using primary care electronic health records from the UK Clinical Practice Research Datalink, we identified adults with recorded diagnosis of FH, statin treatment and measures of LDL-C prior to (baseline) and 12 months after initiating statin treatment. The percentage change in LDL-C was determined, and then baseline and treatment characteristics were assessed by LDL-C treatment goal attainment. Results Of 3064 adults (mean age 50.8 years) with recorded diagnosis of FH and repeat LDL-C measures, 50% reduction in LDL-C from baseline was attained in 895 individuals (29.2%) in 12 months. Compared with those who did not attain this goal, these people were predominantly women; they were older at time of FH diagnosis (53.4 years vs 49.7 years) and first statin treatment (53.2 years vs 49.2 years) and had higher pretreatment total cholesterol (8.20 (SD 1.38) mmol/L vs 7.57 (SD 1.39) mmol/L) and pretreatment LDL-C (5.83 (SD 1.36) mmol/L vs 5.25 (SD 1.40) mmol/L). A higher proportion of individuals who attained the treatment goal was prescribed high-potency and medium-potency statins (24.3% and 71.7% vs 20.2% and 69.3%, respectively). Conclusions Less than a third of individuals on statin treatment for FH in the community achieve recommended reductions in LDL-C. Greater awareness and optimisation of treatment for FH using higher-potency statins are needed. Data are available on reasonable request. The CPRD data analysed during this study are available from the Clinical Practice Research Datalink (CPRD) (enquiries@cprd.com), but restrictions apply to the availability of these data, which were used under license for the current study and so are not publicly available. Data are however available from the authors on reasonable request and with permission of the CPRD Independent Scientific Advisory Committee (ISAC) (enquiries@cprd.com).

中文翻译：

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初级保健中家族性高胆固醇血症患者的他汀类药物治疗和低密度脂蛋白胆固醇治疗目标达到

目标指南建议家族性高胆固醇血症 (FH) 使用他汀类药物治疗，以使低密度脂蛋白胆固醇 (LDL-C) 至少降低 50%。我们评估了初级保健中 FH 患者的他汀类药物处方率和 LDL-C 治疗目标达到情况。方法使用来自英国临床实践研究数据链的初级保健电子健康记录，我们确定了在开始他汀类药物治疗之前（基线）和 12 个月后记录了 FH 诊断、他汀类药物治疗和 LDL-C 测量的成年人。确定 LDL-C 的百分比变化，然后通过 LDL-C 治疗目标达到情况评估基线和治疗特征。结果 在 3064 名成人（平均年龄 50.8 岁）中记录了 FH 诊断并重复 LDL-C 测量，在 12 个月内，895 人 (29.2%) 的 LDL-C 较基线降低了 50%。与没有达到这个目标的人相比，这些人主要是女性；他们在 FH 诊断（53.4 岁 vs 49.7 岁）和首次接受他汀类药物治疗（53.2 岁 vs 49.2 岁）时年龄较大，并且治疗前总胆固醇较高（8.20 (SD 1.38) mmol/L vs 7.57 (SD 1.39) mmol/L ) 和预处理 LDL-C (5.83 (SD 1.36) mmol/L vs 5.25 (SD 1.40) mmol/L)。达到治疗目标的个体比例较高，他汀类药物为强效和中效他汀类药物（分别为 24.3% 和 71.7% 对 20.2% 和 69.3%）。结论 社区中接受他汀类药物治疗的 FH 患者中，只有不到三分之一的人达到了推荐的 LDL-C 降低水平。需要提高对使用高效他汀类药物治疗 FH 的认识和优化。可根据合理要求提供数据。本研究期间分析的 CPRD 数据可从临床实践研究数据链 (CPRD) (enquiries@cprd.com) 获得，但这些数据的可用性受到限制，这些数据是在当前研究的许可下使用的，因此未公开可用的。然而，在合理的要求和 CPRD 独立科学咨询委员会 (ISAC) (enquiries@cprd.com) 的许可下，作者可提供数据。这些是在当前研究的许可下使用的，因此不公开。然而，在合理的要求和 CPRD 独立科学咨询委员会 (ISAC) (enquiries@cprd.com) 的许可下，作者可提供数据。这些是在当前研究的许可下使用的，因此不公开。然而，在合理的要求和 CPRD 独立科学咨询委员会 (ISAC) (enquiries@cprd.com) 的许可下，作者可提供数据。