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Summary   Objectives  The aim of this study was to assess treatment patterns of lipid‐lowering therapy ( LLT ) in patients with hyperlipidaemia or prior cardiovascular ( CV ) events who experience new  CV  events.    Methods  A retrospective population‐based cohort study was conducted using Swedish medical records and registers. Patients were included in the study based on a prescription of  LLT  or  CV  event history and followed up for up to 7 years for identification of new  CV  events and assessment of  LLT  treatment patterns. Patients were stratified into three cohorts based on  CV  risk level. All outcomes were assessed during the year following index (the date of first new  CV  event). Adherence was defined as medication possession ratio ( MPR ) &gt; 0.80. Persistence was defined as no gaps &gt; 60 days in supply of drug used at index.    Results  Of patients with major cardiovascular disease ( CVD ) history ( n  = 6881), 49% were not on  LLT  at index. Corresponding data for  CV  risk equivalent and low/unknown  CV  risk patients were 37% ( n  = 3226) and 38% ( n  = 2497) respectively.  MPR  for patients on  LLT  at index was similar across cohorts (0.74–0.75). The proportions of adherent (60–63%) and persistent patients (56–57%) were also similar across cohorts. Dose escalation from dose at index was seen within all cohorts and 2–3% of patients switched to a different  LLT  after index while 5–6% of patients augmented treatment by adding another  LLT .    Conclusions  Almost 50% of patients with major  CVD  history were not on any  LLT , indicating a potential therapeutic gap. Medication adherence and persistence among patients on  LLT  were suboptimal.

Lipid‐lowering treatment patterns in patients with new cardiovascular events – estimates from population‐based register data in Sweden