LDL cholesterol improved among veterans in program with health coaches, other resources

(Press-News.org) Research Highlights:

After 24 months, 34% of veterans who have heart and blood vessel disease and high cholesterol in a quality improvement program that included health care coaches and other resources had improved cholesterol levels to below 70 mg/dL. The quality-improvement program increased the number of military 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: The study featured in this news release is a research abstract. Abstracts presented at the American Heart Association’s scientific meetings are not peer-reviewed, and the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal. Embargoed until 3:47 p.m. CT/4:47 p.m. ET, Monday, Nov. 10, 2025

This news release contains updated information from the research authors that was not in the abstract.

NEW ORLEANS, Nov. 10, 2025 — A quality improvement program helped reduce “bad cholesterol” (LDL or low-density lipoprotein) levels among military veterans who have heart and blood vessel disease, according to a preliminary late-breaking science presentation today at the American Heart Association’s Scientific Sessions 2025. The meeting, Nov. 7-10, in New Orleans, is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

“Heart disease and stroke are the leading causes of death among veterans, and elevated low-density lipoprotein is a major risk factor for both. While there are medications that work well to lower this bad cholesterol, two-thirds of veterans with heart disease do not have cholesterol treated to goal,” said study author Luc Djoussé, M.D., a research health scientist (cardiovascular epidemiologist) at Massachusetts Veterans Epidemiology Research and Information Collaborative (MAVERIC), the Boston VA Medical Center and an associate professor of medicine at Harvard Medical School, all in Boston. “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. This shows how important it is for veterans to manage their cholesterol levels in order to have longer, healthier lives.”

This study investigated if the quality improvement program would expand the use of cholesterol-lowering medications, improve patient adherence to taking these medications and/or increase the percentage of veterans meeting an LDL-cholesterol goal of below 70 mg/dL.

The study identified barriers to lowering cholesterol, including poor medication adherence among veterans, gaps in health information and education support for veterans and professionals on cholesterol management and lifestyle changes, and staffing shortages at Veterans Affairs health care centers. The quality improvement program addressed these issues with a multipronged approach: health care coaches, multidisciplinary teams, engagement lists for at-risk veterans, improved medication prescribing practices and health information and resources about cholesterol and lifestyle management.

The analysis found:                                                                                                       

A 32% increase in the number of veterans reducing their bad cholesterol below 70 mg/dL during the program. For those who were in the program for at least 2 years and had a second LDL cholesterol measurement, 33.5% achieved the LDL cholesterol goal. This benefit was seen in both men and women and in veterans who were 75 years and older. Among all participants, there was a 15.9 mg/dL reduction in LDL cholesterol, with the greatest reduction occurring among veterans who initially had the highest LDL cholesterol levels. The proportion of veterans being prescribed cholesterol-lowering medication increased from 78% at baseline to 88%, and patient adherence to cholesterol-lowering medications improved from 65% to 77%. These benefits were observed in both men and women. Among veterans ages 75 and older, 36% achieved the goal of LDL cholesterol or less than 70 mg/dL. “We were surprised to see similar reductions in LDL levels among veterans ages 75 and older. This is important because fewer older adults have been included in previous clinical trials of LDL cholesterol medications. This knowledge, if confirmed by ongoing large trials among older adults, could change clinical practice for this age group,” Djoussé said.

The study’s strengths include the large number of participants — veterans of various ages and races, both men and women, which means the results may be more widely applicable to the general population. In addition, the use of a health coach and simple, inexpensive approaches can lead to a significant improvement in cholesterol management.

Limitations include that the program was not designed to evaluate its impact on heart attacks or strokes, so its impact cannot be directly tied to those events. Also, participating veterans were not required to give blood samples at frequent intervals, so researchers relied on LDL cholesterol measurements taken as part of routine clinical care.

Study background, details and design:

Approximately 160,000 veterans with heart and vascular diseases are enrolled in the VALOR-QI program, which started in December 2022 and will conclude in December 2025. This analysis covers data through June 2025 for the select participants in this study. The current analysis is based on 83,232 veterans who had prevalent ASCVD, LDL cholesterol of 70 mg/dL or higher at baseline and had another measurement of LDL cholesterol during the program. Participants’ average age was 70 years old; 7% of participants were women; 69% self-reported they are white adults, and 22% self-identified as Black adults. 50 VA health care sites participated in the VALOR-QI program. Each site is headed by a local clinical champion who leads a team of health care professionals and health care coaches who work with American Heart Association consultants to identify and address site-specific barriers to optimal cholesterol management among participating veterans. Adherence to treatment plans was assessed via prescription refills and cholesterol lab values recorded in participants’ VA electronic health records. In addition to continuing to follow participants’ health, the researchers are evaluating the impact of the quality improvement program on health care costs. “For patients, our study results mean participation in the quality improvement program increased the likelihood of improvement in cardiovascular health. Many tools and strategies used in VALOR-QI were simple, inexpensive and accessible to clinicians and patients at each point of care. This is important for sustainability within the VA system and could lead to adoption of these strategies throughout the vast VA system and also non-VA health care systems,” Djoussé said.

The Veterans Affairs Lipid Optimization Reimagined Quality Improvement (VALOR-QI) program — a collaboration between the Department of Veterans Affairs (VA) and the American Heart Association — is the first large-scale quality-improvement program designed to support former military service personnel with atherosclerotic cardiovascular disease (ASCVD) or who are at high risk of a cardiovascular event. Nearly 160,000 veterans have been engaged in VALOR-QI since it launched in 2022, and the program is supported by Novartis.

The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,380 health care facilities, including 170 VA Medical Centers and 1,193 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9.1 million veterans enrolled in the VA health care program.

Co-authors, disclosures and funding sources are listed in the abstract. Please note: Novartis was not involved in this study.

These statements do not represent the views of the Department of Veterans Affairs or the US government.

Statements and conclusions of studies that are presented at the American Heart Association’s scientific meetings are solely those of the study authors and do not necessarily reflect the Association’s policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. Abstracts presented at the Association’s scientific meetings are not peer-reviewed, rather, they are curated by independent review panels and are considered based on the potential to add to the diversity of scientific issues and views discussed at the meeting. The findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.

The Association receives more than 85% of its revenue from sources other than corporations. These sources include contributions from individuals, foundations and estates, as well as investment earnings and revenue from the sale of our educational materials. Corporations (including pharmaceutical, device manufacturers and other companies) also make donations to the Association. The Association has strict policies to prevent any donations from influencing its science content and policy positions. Overall financial information is available here.

Additional Resources:

Multimedia is available on the right column of the release link View the abstract in the American Heart Association Scientific Sessions 2025 Online Program Planner American Heart Association news release: New program for veterans with high cholesterol, associated cardiovascular disease (March 2023) American Heart Association news release: British veterans severely injured in the Afghanistan War had higher risk of CVD (Nov. 2021) About Scientific Sessions 2025   For more news at the American Heart Association’s Scientific Sessions 2025, follow us on X @HeartNews,#AHA25 ###

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. Dedicated to ensuring equitable health in all communities, the organization has been a leading source of health information for more than one hundred years. Supported by more than 35 million volunteers globally, we fund groundbreaking research, advocate for the public’s health, and provide critical resources to save and improve lives affected by cardiovascular disease and stroke. By driving breakthroughs and implementing proven solutions in science, policy, and care, we work tirelessly to advance health and transform lives every day. Connect with us on heart.org, Facebook, X or by calling 1-800-AHA-USA1.

END