The Spanish Atherosclerosis Society Dyslipidaemia Registry: Evolution, real-world evidence, and its role in precision medicine. Current status in 2026.

INTRODUCTION: The National Dyslipidemia Registry of the Spanish Atherosclerosis Society (SEA) represents a major source of real-world evidence on lipid metabolism disorders in Spain. This study aims to describe the evolution of the registry, its main scientific contributions, and its current role in the development of precision medicine strategies. METHODS: A descriptive study was conducted based on the analysis of the SEA National Dyslipidemia Registry, complemented by a structured review of the main scientific publications derived from it. Studies related to familial hypercholesterolemia, rare dyslipidemias, response to lipid-lowering therapy, artificial intelligence, and lipoprotein(a) were included. Updated data on the number of patients and participating centers were also incorporated. RESULTS: As of March 2026, the registry includes 10,073 patients from 113 lipid units across Spain. The studies derived from the registry have enabled a detailed characterization of the clinical and genetic profile of familial hypercholesterolemia, identified a significant gap in lipid control in routine clinical practice, and demonstrated substantial variability in response to lipid-lowering therapy. In addition, the role of lipoprotein(a) as an independent cardiovascular risk factor has been further elucidated, including its interaction with other lipid parameters and sex-related differences. The registry has also improved the characterization of rare dyslipidemias, such as familial chylomicronemia syndrome and homozygous familial hypercholesterolemia. The incorporation of artificial intelligence models has enhanced cardiovascular risk stratification. CONCLUSIONS: The SEA National Dyslipidemia Registry has become a reference platform for cardiovascular research in real-world settings, supporting the transition toward precision medicine through the integration of clinical, genetic, and analytical data.