Abstract
Background/Objectives: Cardiovascular disease remains a leading cause of mortality in Spain, with dyslipidemia being a major modifiable risk factor. Lipid-lowering therapy (LLT) is essential for cardiovascular risk reduction, but regional disparities in prescription patterns and LDL-C control persist. This study analyzes LLT prescription trends in Spain in 2019 and 2023, assessing temporal, demographic and regional differences. Methods: A retrospective observational study was conducted using the Spanish Primary Care Clinical Database (BDCAP), which contains 4.8 million anonymized primary care records. LLT prescriptions for primary prevention were analyzed by sex, age, community size, and employment status. Trends from 2019 to 2023 were evaluated, distinguishing between monotherapy and combination therapy. Results: In 2023, 5.8 million individuals received LLT for primary prevention (139.6 per 1000). Women had higher treatment rates than men after age 60. Treatment rates were highest in small communities and among retirees. The use of combination therapies almost doubled from 2019 to 2023, achieving better LDL-C control (56.4% vs. 41.5% with monotherapy, p < 0.001). Regional disparities were evident, with the lowest treatment rates in Cataluña and País Vasco and the highest in Galicia. Conclusion: LLT prescription patterns in Spain show remarkable socioeconomic and regional disparities. The increase in combination therapy suggests a shift towards more intensive lipid management. Standardized guidelines and targeted interventions are needed to ensure equitable and effective dyslipidemia treatment.