Abstract Body (Do not enter title and authors here): Background: Shared decision-making aims to improve health outcomes by empowering patients to make informed decisions with their healthcare providers. While decision aids guide treatment choices, they may not help providers effectively communicate the importance of treatment and the risks of non-adherence. We explored patient perspectives on shared decision-making and communication of CVD risks upon diagnosis with elevated LDL-C, a significant risk factor for CVD.

Aims: To learn from people with high cholesterol about their experiences, decisions, and perspectives on being diagnosed and living with high LDL-C, including awareness of the association between high LDL-C and other risk factors for heart disease and stroke.

Methods: The design and interpretation of this cross-sectional, qualitative study were guided by a global multi-disciplinary steering committee. Fifty people with confirmed high LDL-C in Brazil, Australia, and the United States participated in 60-minute interviews between November 2023-March 2024. Half were required to have an ASCVD-related hospitalization. Interview transcripts were thematically analyzed.

Results: Table 1 describes participant characteristics. During their high-LDL-C diagnosis encounter, participants often described being overwhelmed by multiple concurrent diagnoses, unfamiliar medical terms, and concerns about elevated cardiac risk. Most participants stated that their primary source of information, upon diagnosis and throughout their experiences with high LDL-C, is their HCP. Some described underestimating cardiac risks if treatment plans included lifestyle changes only or if discussions focused primarily on comorbidities. Reflecting on time between diagnosis and an ASCVD event, many participants acknowledged they had not taken their care plan as seriously as they should have. Participants offered messages and suggestions for communicating effectively with others with high LDL-C at diagnosis and regularly after diagnosis (see Table 2).

Conclusions: Findings highlight an opportunity to improve cardiovascular care by overcoming indifference towards high LDL-C. Effective communication by healthcare providers at diagnosis and beyond, such as emphasizing the severity of high cholesterol and providing a realistic care plan, is crucial.