This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (59)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in this journal  Social Bookmarking   What's this?

Michael Miller, MD; Robert Byington, PhD; Donald Hunninghake, MD; Bertram Pitt, MD; Curt D. Furberg, MD, PhD; for the Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT) Investigators

Arch Intern Med. 2000;160:343-347.

Background  The efficacy of lipid-lowering therapy (LLT) has been well established for patients with preexisting coronary artery disease (CAD). However, limited information is available assessing the extent to which these medications are prescribed in academic medical centers.

Methods  The use of LLT for patients with CAD was prospectively evaluated in 825 men and women who were recruited from 16 academic medical centers in the United States and Canada to participate in the Prospective Evaluation of the Vascular Events of Norvasc Trial (PREVENT). The assessment of LLT use during the 3-year trial was evaluated in patients receiving amlodipine therapy and placebo; levels of low-density lipoprotein cholesterol (LDL-C) were used to assess the impact of LLT.

Results  Despite a baseline prevalence of LLT in 42% of men (38% in 1994), half of the patients had high levels of LDL-C (>3.36 mmol [>130 mg/dL]). During the subsequent 3 years, the prevalence of elevated LDL-C levels dropped in men (29%) but remained stagnant in women (48%). These changes were associated with increased LLT in men (55%) but not in women (35%) (P = .04). In 1994, the LDL-C target goal (<2.59 mmol/L [<100 mg/dL]) was attained in 17% of men and 6% of women (P = .006). At study completion in 1997, the LDL-C target goal was achieved in 31% of men and only 12% of women (P = .001).

Conclusions  This study highlights the relatively low treatment rates of hyperlipidemia among patients with CAD overall and women in particular who were participating in a clinical trial at academic medical centers in the United States and Canada. Because LLT has been proven to reduce future cardiovascular events, these results suggest that more intensive efforts should be promoted in order to maximize CAD reduction.

From the Department of Medicine, University of Maryland Medical Center, Baltimore (Dr Miller); the Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (Drs Byington and Furberg); the Department of Medicine, University of Minnesota School of Medicine, Minneapolis (Dr Hunninghake); and the Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor (Dr Pitt).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Underutilization of Lipid-Lowering Therapy in Coronary Artery Disease
Alberto Batalla, Sergio Hevia, Julián R. Reguero, and Gustavo I. Cubero
Arch Intern Med. 2000;160(17):2683-2684.
EXTRACT | FULL TEXT  

Lipid-Lowering Therapy in Patients With Coronary Artery Disease: Sex or Age Bias?
Antonio Sgadari, Raffaele Antonelli Incalzi, Graziano Onder, Claudio Pedone, and Giovanni Gambassi
Arch Intern Med. 2000;160(17):2684-2685.
EXTRACT | FULL TEXT  

Toward Better Therapy of Hypercholesterolemia
Ester Laubach, Carsten Otto, Peter Schwandt, Michael Miller, and Robert Byington
Arch Intern Med. 2000;160(17):2685-2686.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 2000;160(3):397-398.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non-ST-Elevation Myocardial Infarction) Developed in Collaboration With the American Academy of Family Physicians and American College of Emergency Physicians Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, Society for Cardiovascular Angiography and Interventions, and Society of Hospital Medicine
Krumholz et al.
J Am Coll Cardiol 2008;52:2046-2099.
FULL TEXT  

ACC/AHA 2008 Performance Measures for Adults With ST-Elevation and Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures (Writing Committee to Develop Performance Measures for ST-Elevation and Non-ST-Elevation Myocardial Infarction): Developed in Collaboration With the American Academy of Family Physicians and the American College of Emergency Physicians: Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation, Society for Cardiovascular Angiography and Interventions, and Society of Hospital Medicine
WRITING COMMITTEE MEMBERS et al.
Circulation 2008;118:2596-2648.
FULL TEXT  

Implementation of proven interventions in general medical inpatients: development and evaluation of a new quality indicator for drug therapy
Huang et al.
Qual Saf Health Care 2008;17:269-274.
ABSTRACT | FULL TEXT  

The importance of study design strategies in gender bias research: the case of respiratory disease management in primary care
Ruiz-Cantero et al.
J. Epidemiol. Community Health 2007;61:ii11-ii16.
ABSTRACT | FULL TEXT  

Statin use in American Indians and Alaska Natives with coronary artery disease.
Cooke et al.
Am J Health Syst Pharm 2006;63:1717-1722.
ABSTRACT | FULL TEXT  

Twenty-Year Trends in Serum Cholesterol, Hypercholesterolemia, and Cholesterol Medication Use: The Minnesota Heart Survey, 1980-1982 to 2000-2002
Arnett et al.
Circulation 2005;112:3884-3891.
ABSTRACT | FULL TEXT  

Perspectives on Dyslipidemia and Coronary Heart Disease in Women
Bittner
J Am Coll Cardiol 2005;46:1628-1635.
ABSTRACT | FULL TEXT  

Addressing Cardiovascular Disease in Women: Focus on Dyslipidemia
Meagher
J Am Board Fam Med 2004;17:424-437.
ABSTRACT | FULL TEXT  

Improvements in 1-Year Cardiovascular Clinical Outcomes Associated with a Hospital-Based Discharge Medication Program
Lappe et al.
ANN INTERN MED 2004;141:446-453.
ABSTRACT | FULL TEXT  

Ethnic and Sex Differences in the Prevalence, Treatment, and Control of Dyslipidemia Among Hypertensive Adults in the GENOA Study
O'Meara et al.
Arch Intern Med 2004;164:1313-1318.
ABSTRACT | FULL TEXT  

In-Hospital Initiation of Lipid-Lowering Therapy After Coronary Intervention as a Predictor of Long-term Utilization: A Propensity Analysis
Aronow et al.
Arch Intern Med 2003;163:2576-2582.
ABSTRACT | FULL TEXT  

Determination of Lipid Profiles and Use of Statins in Patients With Ischemic Stroke or Transient Ischemic Attack
Lalouschek et al.
Stroke 2003;34:105-110.
ABSTRACT | FULL TEXT  

Adherence to statin treatment and readmission of patients after myocardial infarction: a six year follow up study
Wei et al.
Heart 2002;88:229-233.
ABSTRACT | FULL TEXT  

Task Force #4--adherence issues and behavior changes: achieving a long-term solution
Ockene et al.
J Am Coll Cardiol 2002;40:630-640.
FULL TEXT  

Supplemental Insurance and Use of Effective Cardiovascular Drugs Among Elderly Medicare Beneficiaries With Coronary Heart Disease
Federman et al.
JAMA 2001;286:1732-1739.
ABSTRACT | FULL TEXT  

Lipid Disorders : Justification of Methods and Goals of Treatment
Braunstein et al.
Chest 2001;120:979-988.
ABSTRACT | FULL TEXT  

Improving Lipid Evaluation and Management in Medicare Patients Hospitalized for Acute Myocardial Infarction
Malach et al.
Arch Intern Med 2001;161:839-844.
ABSTRACT | FULL TEXT  

Use of Lipid-Lowering Medications at Discharge in Patients With Acute Myocardial Infarction : Data From the National Registry of Myocardial Infarction 3
Fonarow et al.
Circulation 2001;103:38-44.
ABSTRACT | FULL TEXT  

Underutilization of Lipid-Lowering Therapy in Coronary Artery Disease
Batalla et al.
Arch Intern Med 2000;160:2683-2684.
FULL TEXT  

Lipid-Lowering Therapy in Patients With Coronary Artery Disease: Sex or Age Bias?
Sgadari et al.
Arch Intern Med 2000;160:2684-2685.
FULL TEXT  

Toward Better Therapy of Hypercholesterolemia
Laubach et al.
Arch Intern Med 2000;160:2685-2686.
FULL TEXT  

"We Don't Carry That"
Saha et al.
NEJM 2000;343:442-445.
FULL TEXT