Evidence map›Paper›PMID 40999327›Full record

ArticleBMC primary care2025

Shift in therapeutic approaches in patients with hypercholesterolemia - a secondary data analysis.

Elena Zink, Jost Steinhäuser, Paul-Georg Blickle, Wolfgang C G von Meißner, Christoph Strumann

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Research Status and Latest Progress in the Regulatory Mechanisms of ABCA1.International journal of molecular sciences · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elena ZinkInstitute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, 23538, Germany. elena.zink@student.uni-luebeck.de.
Jost SteinhäuserInstitute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, 23538, Germany.
Paul-Georg BlickleInstitute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, 23538, Germany.
Wolfgang C G von MeißnerInstitute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, 23538, Germany.
Christoph StrumannInstitute of Family Medicine, University Medical Centre Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, 23538, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtherosclerotic cardiovascular disease is a leading cause of death and hypercholesterolemia is one relevant risk factor. There are two established guidelines for the management of high cholesterol in general practice in Germany, one of these is from the European Society of Cardiology (ESC). This analysis examines whether treatment modalities and clinical outcomes in German primary care have changed after the publication of the 2019 ESC (European Society of Cardiology)/EAS (European Atherosclerosis Society) guidelines on dyslipidaemia.

methodsA retrospective cohort study (2001-2023) with data extracted from electronic health record systems of 17 primary care practices. The Data was used to compare drug treatment and outcomes before and after 2019, the year of the ESC guideline publication. Multilevel regression analysis was used to assess the effects of the new guidelines, accounting for time trends and patient- and practice-level factors.

resultsStatin prescriptions for 23,322 patients with hypercholesterolemia increased from 6% in 2001 to 27% in 2023, with an increase in treatment intensity after 2012. Despite general reductions in total and LDL cholesterol, cardiovascular events remained unchanged, while reported complaints associated with side effects increased. Multilevel regression showed more prescriptions after the new ESC/EAS guidelines, with no effect on treatment intensity or outcomes.

conclusionFollowing the publication of the new ESC/EAS guideline, a modest rise in statin prescriptions has been documented. However, despite improved lipid profiles, clinically relevant events did not decrease yet, and side effects increased, questioning the benefit of tailoring statin therapy to lower lipid thresholds in real world data so far.

trial registrationGerman Clinical Trials Register: DRKS00032936. Registration Date: October 30, 2023.

Indexed as

Hydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaPractice Patterns, Physicians'AgedFemaleGermanyHumansMaleMiddle AgedPractice Guidelines as TopicPrimary Health CareRetrospective StudiesSecondary Data AnalysisHydroxymethylglutaryl-CoA Reductase InhibitorsCardiovascular diseasesGuidelineHypercholesterolemiaPrimary careStatin

Identifiers

PMID40999327
PMCPMC12462300

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.