The National Lipid Association (NLA) and Foundation of the National Lipid Association (FNLA) Urge CMS and Administrator Oz to Include Low-Density Lipoprotein Cholesterol (LDL-C) Measurement in CMS Quality Measurement Programs
JACKSONVILLE, Fla., May 19, 2025 /PRNewswire/ -- The National Lipid Association (NLA) and Foundation of the National Lipid Association (Foundation) urge the Centers for Medicare & Medicaid Services (CMS) and recently confirmed CMS Administrator, Dr. Mehmet C. Oz, to help increase measurement and management of low-density lipoprotein cholesterol (LDL-C) through CMS quality measurement programs. Effective LDL-C management is essential to addressing atherosclerotic cardiovascular disease (ASCVD) — the United States' leading cause of death. Following more than 40 years of decline, death related to ASCVD has been on the rise for over a decade, accompanied by decreased rates of LDL-C measurement and accompanying CMS incentives.
To address the ASCVD chronic disease crisis, Christie M. Ballantyne, MD, President of the NLA stated:
There is overwhelming evidence that lowering LDL-C leads to a proportional decrease in ASCVD risk and that LDL-C is a reliable and established measure of atherogenic lipoproteins; however, there is also irrefutable evidence that clinicians are not measuring or managing LDL-C as recommended by the American Heart Association, American College of Cardiology, multisociety guidelines.
Existing guidelines from the American Heart Association, American College of Cardiology, and other leading organizations provide the highest level of evidence support for measuring LDL-C in patients with ASCVD, including:
Adherence to changes in lifestyle and effects of LDL-C lowering medications should be assessed by measurement of fasting lipids and appropriate safety indicators 4 to 12 weeks after statin initiation or dose adjustment and every 3 to 12 months thereafter based on need to assess adherence or safety.[i],[ii]
Recent data shows that only 29.9% of Medicare beneficiaries had LDL-C measured within 90 days of hospital discharge for myocardial infarction,[iii] only 49.9% of patients with ASCVD are on any statin therapy.[iv]
With LDL-C a well-established causal risk factor for ASCVD progression and clear guidance from the leading organizations in the United States, CMS quality measures could play a greater role in increasing LDL-C measurement and management. "Existing measures that consider whether a patient received a prescription for a statin or was dispensed a statin are not consistent with the standard of care, as those measures fail to assess whether the patient is taking their medication or if the medication is working as intended," continued Ballantyne.
"Quality measures can incentivize and prioritize care for many clinicians and patients. Improving existing quality measures to focus on measuring lipids, including LDL-C, will provide the necessary information to clinicians to improve prevention of cardiovascular events and empower patients to make informed decisions about their health," stated James A. Underberg, MD, MNLA, President of the Foundation.
The NLA and Foundation of the NLA welcome any opportunity to work with CMS and Dr. Oz toward helping develop evidence-based updates, quality measures, or other interventions to help stem the ASCVD crisis – with a focus on effective LDL-C measurement and management.
For media inquiries, please contact Brian Hart, Executive Director of the National Lipid Association, at exec@lipid.org.
About the National Lipid Association:The National Lipid Association (NLA) is a nonprofit, multidisciplinary medical society focused on enhancing the science and practice of lipidology and promote optimal cardiometabolic health, representing more than 2,200 members throughout the United States. The NLA is the leader in this field, having published numerous clinical recommendations for lipid management, served as a co-author of the 2018 American Heart Association/American College of Cardiology/Multisociety cholesterol guidelines and 2023 American Heart Association/American College of Cardiology/Multisociety chronic coronary disease guidelines, and serves as the primary educator and advocate for clinical lipidology. Website: www.lipid.org.
About the Foundation of the National Lipid AssociationThe Foundation of the National Lipid Association is a 501(c)(3) nonprofit organization focused on improving the welfare of patients and families affected by cholesterol and triglyceride problems. The Foundation of the National Lipid Association develops and maintains resources for patients, families, and caregivers for common and rare cholesterol and triglyceride disorders to support management of lipid-related health problems that may put patients at risk for a heart attack or stroke. Website: www.learnyourlipids.com.
i Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, Braun LT, de Ferranti S, Faiella-Tommasino J, Forman DE, Goldberg R, Heidenreich PA, Hlatky MA, Jones DW, Lloyd-Jones D, Lopez-Pajares N, Ndumele CE, Orringer CE, Peralta CA, Saseen JJ, Smith SC Jr, Sperling L, Virani SS, Yeboah J. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/ APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;139:e1082e.ii Virani SS, Newby LK, Arnold SV, Bittner V, Brewer LC, Demeter SH, Dixon DL, Fearon WF, HessB, Johnson HM, Kazi DS, Kolte D, Kumbhani DJ, LoFaso J, Mahtta D, Mark DB, Minissian M, Navar AM, Patel AR, Piano MR, Rodriguez F, Talbot AW, Taqueti VR, Thomas RJ, vanDiepen S, Wiggins B, Williams MS. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the AmericanHeart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148:e9–e119. doi: 10.1161/CIR.0000000000001168.iii Nelson, A, Haynes, K, Shambhu, S. et al. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. JACC. 2022 May, 79 (18) 1802–1813.https://doi.org/10.1016/j.jacc.2022.02.048.iv Colantonio, L, Wang, Z, Jones, J. et al. Low-Density Lipoprotein Cholesterol Testing Following Myocardial Infarction Hospitalization Among Medicare Beneficiaries. JACC Adv. 2024 Jan, 3 (1). https://doi.org/10.1016/j.jacadv.2023.100753.
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