Quality Enhancement Program Lowers “Bad Cholesterol” in Veterans with heart Disease
NEW ORLEANS, Nov. 10, 2025 – A quality improvement program effectively reduced “bad cholesterol” (LDL or low-density lipoprotein) levels among military veterans with heart and blood vessel disease, according to research presented today at the American heart Association’s Scientific Sessions 2025.
Heart disease and stroke are leading causes of death among veterans, with elevated LDL being a major risk factor. While medications exist to lower LDL cholesterol, two-thirds of veterans with heart disease don’t reach recommended cholesterol levels. “Lowering LDL cholesterol reduces the chances of having another heart attack or stroke.For veterans, keeping LDL cholesterol levels low leads to better heart health and reduces health care costs,” said Luc Djoussé, M.D.,a research health scientist at Massachusetts Veterans Epidemiology Research and Details Collaborative (MAVERIC),the Boston VA medical center and an associate professor of medicine at Harvard Medical School. “This shows how significant it is indeed for veterans to manage their cholesterol levels in order to have longer, healthier lives.”
The study investigated whether a quality improvement program could expand the use of cholesterol-lowering medications, improve patient adherence, and increase the percentage of veterans achieving an LDL-cholesterol goal of below 70 mg/dL. Researchers identified barriers including poor medication adherence, gaps in health information, and staffing shortages.
The program addressed these issues through health care coaches, multidisciplinary teams, engagement lists for at-risk veterans, improved prescribing practices, and health resources about cholesterol and lifestyle management.
Key findings include:
* A 32% increase in the number of veterans reducing their LDL cholesterol below 70 mg/dL during the program.
* 33.5% of participants with at least two years in the program achieved the LDL cholesterol goal, with benefits seen in both men and women, including those 75 and older.
* An average 15.9 mg/dL reduction in LDL cholesterol, most significant among veterans with initially high levels.
* An increase in the proportion of veterans prescribed cholesterol-lowering medication from 78% to 88%, with improved adherence from 65% to 77%.
* 36% of veterans ages 75 and older achieved an LDL cholesterol level of less than 70 mg/dL.
“We were surprised to see similar reductions in LDL levels among veterans ages 75 and older,” Djoussé noted. “This is important because fewer older adults have been included in previous clinical trials of LDL cholesterol-lowering therapies.”
Research Highlights:
* After 24 months, 34% of veterans with heart and blood vessel disease and high cholesterol in the program had improved cholesterol levels to below 70 mg/dL.
* The program increased the number of veterans with better LDL (“bad” cholesterol) levels of less than 70mg/dL, and more than a third of those ages 75 and older achieved their lower cholesterol goal.
Note: This study is a research abstract and has not yet undergone peer review. Findings are considered preliminary until published in a peer-reviewed journal.
Summary of the VALOR-QI Program study
Here’s a breakdown of the key information from the provided text regarding the Veterans Affairs Lipid Optimization Reimagined Quality Improvement (VALOR-QI) program:
What is VALOR-QI?
* A large-scale quality improvement program (launched December 2022, concluding December 2025) designed to support veterans with atherosclerotic cardiovascular disease (ASCVD) or at high risk of cardiovascular events.
* A collaboration between the Department of Veterans Affairs (VA) and the American Heart Association.
* Currently engaging nearly 160,000 veterans.
* supported by Novartis (though Novartis was not involved in this specific study).
Study Details (Analysis through June 2025):
* Participants: 83,232 veterans with existing ASCVD and LDL cholesterol of 70 mg/dL or higher at the start of the program.
* Demographics: Average age 70; 7% women; 69% White, 22% Black.
* Sites: 50 VA healthcare sites, each led by a “clinical champion” and a team including health coaches and consultants from the American Heart Association.
* Assessment: Adherence to treatment plans was tracked via prescription refills and cholesterol lab values in VA electronic health records.
* Ongoing Evaluation: Researchers are also evaluating the program’s impact on healthcare costs.
Key Findings/Strengths:
* Improved Cardiovascular Health: Participation in the program increased the likelihood of improved cardiovascular health.
* Widely Applicable Results: The diverse participant group (age, race, gender) suggests the results may be applicable to a broader population.
* Simple & Inexpensive: The program utilizes simple, inexpensive approaches, making it sustainable and perhaps adoptable by other healthcare systems.
Limitations:
* No Direct Impact on Heart Attacks/Strokes: The program wasn’t designed to specifically measure the impact on heart attacks or strokes.
* Reliance on routine Data: Researchers relied on LDL cholesterol measurements taken as part of standard clinical care, rather than frequent blood samples specifically for the study.
Critically important Notes:
* The findings are preliminary and have not yet been peer-reviewed (presented at an American Heart Association scientific meeting).
* The statements do not necessarily reflect the views of the Department of Veterans Affairs or the US government.
Source: Public Release (link not provided in the text, but indicated at the end).