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A Multicenter Survey to Evaluate the Percentages of Dyslipidemic Patients Receiving Lipid-Lowering Therapy and Achieving Low-Density Lipoprotein Cholesterol Goals

Thomas A. Pearson, MD, PhD, MPH; Irene Laurora, PharmD; Henry Chu, MS; Stephanie Kafonek, MD

Arch Intern Med. 2000;160:459-467.

Objective  To determine the percentage of patients in the multicenter Lipid Treatment Assessment Project receiving lipid-lowering therapy who are achieving low-density lipoprotein cholesterol (LDL-C) goals as defined by National Cholesterol Education Program (NCEP) guidelines.

Methods  Adult patients with dyslipidemia, who had been receiving the same lipid-lowering therapy for at least 3 months, were assessed at investigation sites. Lipid levels were determined once in each patient at the time of enrollment. The primary end point was the success rate, defined as the proportion of patients who achieved their LDL-C target level as specified by NCEP guidelines.

Results  A total of 4888 patients from 5 regions of the United States were studied. Of these, 23% had fewer than 2 risk factors for coronary heart disease (CHD) and no evidence of CHD (low-risk group), 47% had 2 or more risk factors and no evidence of CHD (high-risk group), and 30% had established CHD. Overall, only 38% of patients achieved NCEP-specified LDL-C target levels; success rates were 68% among low-risk patients, 37% among high-risk patents, and 18% among patients with CHD. Drug therapy was significantly (P.001) more effective than nondrug therapy in all patient risk groups. However, many patients treated with lipid-lowering drugs did not achieve LDL-C target levels.

Conclusions  Large proportions of dyslipidemic patients receiving lipid-lowering therapy are not achieving NCEP LDL-C target levels. These findings indicate that more aggressive treatment of dyslipidemia is needed to attain goals established by NCEP guidelines.

From the Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, NY (Dr Pearson); and Parke-Davis Co, Morris Plains, NJ (Drs Laurora and Kafonek and Mr Chu).

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