Newton SL, Hoffmann AP, Yu Z, et al. - The risks related to persistent moderate hypercholesterolemia in young adulthood are significantly underrecognized, and observations from this study call for strategies to promote guideline-recommended cholesterol management in young adults.

• Contemporary real-world management of hypercholesterolemia in young adults is not properly reported.

• Clinical registry data were used to study 2 cohorts of patients who were 20 to 39 years old at the time of a qualifying low-density lipoprotein cholesterol (LDL-C): cohort 1 included people with an LDL-C value of 190 mg/dL or greater, and cohort 2 included those with an LDL-C value between 160 and less than 190 mg/dL.

• Guideline-directed LDL-C reduction (≥50%) was achieved in fewer than 1 in 3 young adults with severe hypercholesterolemia, and about 1 in 4 exhibited an LDL-C level persistently 190 mg/dL or greater, over 8 years of observation, in a large health care system including multiple academic and community-based practice sites.

• Lipid-lowering therapy (LLT) was prescribed to fewer than half of patients with an LDL-C level of 190 mg/dL or greater.

• Females and younger patients showed lower likelihood of prescription for LLT and achievement of LDL-C reduction.

• There were lower rates of LLT prescription and LDL-C decrease in women.

• As anticipated, even less LDL-C lowering was achieved among young adults with moderate hypercholesterolemia.