Aycan ÇİÇEKLİ, Yasemin SAĞLAN
Türkiye Aile Hekimliği Dergisi - 2026;30(1):40-52
Objective: Statins are commonly used in the management of dyslipidemia, with their efficacy varying based on type and dose. They are prescribed for both primary and secondary cardiovascular prevention. However, achieving recommended low-density lipoprotein cholesterol (LDL-C) targets remains a challenge in clinical practice. This study aimed to assess achievement of target LDL-C levels in statin users and to identify modifiable factors related to treatment failure. Methods: This cross-sectional study was conducted in a family medicine outpatient clinic and included adults (>=18 years) on statin therapy for at least six months. Data were collected through face-to-face interviews using a sociodemographic questionnaire and the Adherence to Refills and Medications Scale (ARMS -7). Cardiovascular risk levels were classified using the SCORE risk calculator, and LDL-C goal attainment was assessed based on risk categories. Results: Of 334 participants, 51.8% were male. LDL-C levels exceeded 100 mg/dL in 43.1% of patients. According to SCORE classifications, 55.4% were identified as being at very high cardiovascular risk. Overall, 87.1% of participants failed to achieve target LDL-C levels. Target LDL-C levels were achieved by 30.4% of participants in the low-to-moderate risk group, 16.5% in the high-risk group, and only 6.5% in the very high-risk group (p<0.001). In the study population, patients using statins solely for dyslipidemia (without a history of cardiovascular disease) and those with hypertension, were more likely to achieve LDL-C targets (p<0.05). A significantly higher proportion of male participants (16.8%) achieved the target LDL-C level compared to female participants (8.7%) (p<0.05). Conclusion: The majority of patients on statin therapy did not meet their target LDL-C levels, particularly those at high cardiovascular risk, highlighting the impact of clinical inertia and underscoring the importance of individualized statin dosing and regular monitoring based on patients' cardiovascular risk assessments in primary care settings.
