Background and aims: Current population-based data on cardiovascular risk and lipid target achievement in Mediterranean populations are limited. We assessed cardiovascular risk, lipid-lowering treatment, and low-density lipoprotein cholesterol control in the province of Huelva, southern Spain.Methods: MAPA-Huelva was a cross-sectional, population-based study of 318 participants selected using stratified random sampling. Cardiovascular risk was classified according to 2021 European Society of Cardiology criteria using SCORE2, SCORE2-OP, and, when applicable, SCORE2-Diabetes. Attainment of risk-specific absolute low-density lipoprotein cholesterol goals was assessed.Results: Hypertension, diabetes, and dyslipidaemia were present in 43.1%, 13.8%, and 46.2% of participants, respectively. Among classifiable participants, 32.3% were at high or very high risk. Lipid-lowering therapy use increased across risk categories (9.2%, 23.9%, 51.8%, and 71.8%; p <0.001), whereas low-density lipoprotein cholesterol goal attainment decreased (61.4%, 24.4%, 14.8%, and 15.8%; p <0.001). Only 15.2% of high- or very-high-risk participants with available low-density lipoprotein cholesterol attained their goal; among those above goal, 46.2% were untreated. In exploratory adjusted analysis, older age and current smoking were associated with goal non-attainment, whereas lipid-lowering therapy was associated with lower odds of being above goal (odds ratio 0.15, 95% confidence interval 0.06–0.37; p<0.001).Conclusions: Almost one-third of classifiable participants in this contemporary Mediterranean population were at high or very high cardiovascular risk. Gaps in treatment initiation, intensity, and low-density lipoprotein cholesterol goal attainment support more systematic implementation of guideline-directed lipid management.

Background Detecting total cholesterol in dried blood spots could aid in identifying individuals with a high likelihood of familial hypercholesterolemia and could be used as a screening measure. This study aims to assess the diagnostic accuracy of dried blood spots on Whatman 903 paper cards using a manual enzymatic technique. Methods: A total of 394 samples were collected as serum and dried blood spots were compared. Cholesterol was determined in serum using the automated reference method, while cholesterol on paper was measured using a manual enzymatic method. Within- and between-day diagnostic variability were analyzed. The correlation between both methods was assessed using Passing–Bablok regression and Bland–Altman plot. Internal validation of our correlation formula was performed on 149 samples, along with external validation of the formula proposed by Corso et al. Results: The within- and between-day coefficient of variation was found to be lower than 10.14% and 14.09%, respectively. Passing–Bablok regression indicated a precision of 0.803 and an accuracy of 0.96. Internal validation precision was measured at 0.716. The resulting positive and negative predicted values were 0.77 and 0.92, respectively, vs. 0.46 and 0.96 from the external formula. Conclusions: Total cholesterol analysis in dried blood spots demonstrates high precision and reproducibility. This method reliably enables the incorporation of this biological marker into neonatal screening for familial hypercholesterolemia detection.