Abstract

Introduction: Dyslipidemia, particularly elevated serum low-density lipoprotein cholesterol (LDL-C), plays a crucial role in the development and progression of atherosclerosis. This study aimed to determine the rate of LDL-C non-achievement according to the European Society of Cardiology/European Atherosclerosis Society 2019 (ESC/EAS 2019) guidelines and related factors in the elderly.

Methods: This was a cross-sectional study involving 555 individuals (age 69.30 ± 6.54, male/female ratio 4.55/1) in an outpatient clinic in Ca Mau province from October 2020 to June 2021. Demographic information, medical history, clinical characteristics, and tested cholesterol, including LDL-C level, were collected to assess cardiovascular risk and determine factors related to LDL-C control status.

Results: The non-achievement rate of the LDL-C goal in participants was 77.1%. In the adjusted model, factors associated with an increased risk of non-achievement of the LDL-C goal were non-adherence to treatment (odds ratio (OR) 7.75, 95% confidence interval (CI) 3.65-16.47, p < 0.001), being at very high risk (OR 15.48, 95% CI 6.34-37.76, p < 0.001), and at high risk (OR 4.03, 95% CI 2.20-7.40, p < 0.001). Conversely, factors related to a decreased risk were exercise (OR 0.53, 95% CI 0.30-0.95, p = 0.032) and a history of myocardial infarction or unstable angina (OR 0.192, 95% CI 0.05-0.72, p = 0.014), or coronary revascularization (OR 0.20, 95% CI 0.08-0.48, p < 0.001).

Conclusions: The rate of non-achievement in the LDL-C goal among participants was notable. Non-adherence to treatment and classification as high to very high risk were identified as factors associated with an increased risk of non-achievement of LDL-C, while regular exercise was linked to a decreased risk. This study emphasizes the necessity of an aggressive strategy for high and very high-risk groups with a comprehensive approach incorporating pharmacological and non-pharmacological individual treatment for achieving the LDL-C target.