Cardiovascular Health

LDL-cholesterol achievement of target (ages 35-74 years, target is set by risk-level)

Individuals who had achieved the identified LDL-cholesterol target (numerator), among Individuals aged 35-74 years with documented risk factors for heart disease (denominator)

Rational:

Atherosclerosis, which may lead to acute myocardial infraction and stroke, is a disease in which plaque builds up inside arteries, causing them to harden and narrow over time. One of the main causes for plaque accumulation has been shown to be high blood-cholesterol levels [1]. The current Israeli guidelines (March 2018) set target values for LDL-cholesterol in individuals according to their level of risk for heart disease [2]. This approach is based on the strong evidence for the existence of a causal relationship between blood LDL-cholesterol levels and cardiovascular morbidity, shown by numerous randomized trials that explored the efficacy and safety of cholesterol-lowering treatment [3], and is in accordance with the recommendations of the European Society of Cardiology and the European Atherosclerosis Society [4].

Numerator:

Individuals in the denominator who had achieved the identified LDL-cholesterol target

Denominator

Individuals aged 35-74 years with documented risk factors for heart disease This composed indicator combines the following criteria (for individuals aged 35-74 year):• LDL-cholesterol level<= 160 mg/dL among individuals at low-risk for heart disease• LDL-cholesterol level <= 130 mg/dL among individuals at medium-risk for heart disease• LDL-cholesterol level <=100 mg/dL among individuals at high-risk for heart disease

Notes:

None

Notes:

[1] Silverman MG et al., Association between Lowering LDL-C and Cardiovascular Risk Reduction among Different Therapeutic Interventions: A Systematic Review and Meta-analysis. JAMA. 2016 Sep 27;316(12):1289-97. doi: 10.1001/jama.2016.13985.
[2] In Hebrew: עדכון ההנחיות לטיפול בהיפרליפידמיה 2014 - עיקרי ההמלצות. החברה לחקר, מניעה וטיפול בטרשת העורקים, האיגוד לקרדיולוגיה בישראל, האיגוד הישראלי לרפואה פנימית, איגוד רופאי המשפחה, החברה הישראלית ליתר לחץ דם, האגודה הישראלית לסוכרת, האיגוד לנירולוגיה בישראל, העמותה הרפואית למניעה ולגמילה מעישון בישראל, והחברה הישראלית לתזונה קלינית
[3] Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010; 37:1670-81.
[4] Catapano AL, Reiner Z, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis. 2011; 217:3-46

Results:
LDL-cholesterol achievement of target by year
LDL-cholesterol achievement of target by socio-economic position (1-lowest, 4-highest) and sex


National Program for Quality Indicators in Community Healthcare
התכנית הלאומית למדדי איכות לרפואת הקהילה בישראל