In notes on 28,113 people, most of those above their LDL goal had no escalation of lipid-lowering therapy

What the research found

JAMA Cardiology published a cohort study on 7 November 2026. Fatima Rodriguez and colleagues reviewed notes on people with atherosclerotic cardiovascular disease. Of 28,113 people, 13,810 (49.1 percent) had LDL cholesterol above their goal. Mean age was 70.9 years (standard deviation 11.4), and 7,904 were male (57.2 percent). Ages 18 to 90 were eligible. A large language model read the notes. It marked an LDL cholesterol target in 3,756 of 13,394 notes (28.1 percent). Lipid-lowering therapy was not escalated in 11,842 of the relevant notes (88.7 percent). Of these notes, 4,788 (40.4 percent) contained at least one reason. The reasons most often recorded were patient-reported adverse effects (1,683; 12.6 percent), LDL cholesterol close to the goal (922; 6.9 percent), a preference to avoid lipid-lowering therapy (914; 6.8 percent), a preference for lifestyle changes (811; 6.1 percent), and deferral of repeat lab tests (617; 4.6 percent). Agreement scores (F1) ran from 0.80 to 0.98. Notes ran from 1 January 2019 through 15 May 2025. This is a review of notes. It is not advice about care. The eligibility span is 18 to 90, so the card is not limited to one age band even though the mean age is 70.9. DOI 10.1001/jamacardio.2026.5230. Not medical advice.

Evidence level: Human study. A study in people, but an association isn't proof of cause.

Read the original at JAMA Cardiology