Achievement of optimal combined lipid values in a managed care setting: Is a new treatment paradigm needed?

Impact of optimal lipid value achievement between 2005 and 2009 in patients with mixed dyslipidaemia on cardiovascular event rates

“…Statins were the most commonly prescribed lipidmodifying therapy in our study. This is consistent with clinical practice and other studies, as use of sta- tin monotherapy has ranged from 87% to 96% of prescribed dyslipidaemia medications in other realworld trials (9,17). We also observed low utilisation of fibrates and niacin, therapies with pharmacological properties that exert more of their effect on TG and HDL-C.…”

Molecular sources of residual cardiovascular risk, clinical signals, and innovative solutions: relationship with subclinical disease, undertreatment, and poor adherence: implications of new evidence upon optimizing cardiovascular patient outcomes

“…However, only about 29% of those at high risk reach the current goal of LDL cholesterol ≤1.81 mmol/L (70 mg/dL). In one series of mixed primary and secondary prevention patients treated for 36 months in a managed care setting, 78% failed to attain optimal values of LDL cholesterol, HDL cholesterol, and triglycerides 430. The latest data (from NHANES 1988–1992 and 2-year cycles from 1999 to 2008) show that improvements in population cardiovascular health lag well behind those that are required 431…”

Achieving optimal lipid values in patients with dyslipidemia is associated with reduced risk of cardiovascular events

“…This observed high prevalence of multiple lipid abnormalities and low rates of combined lipid value achievement within desirable levels appears in part to be related to underutilization of guideline-recommended pharmacotherapy, in particular therapy targeted to HDL-C and TG abnormalities. [13][14][15][16] The potential for this is noteworthy, as the population-based risk of CV events over time appears to be significantly lower in patients who have desired levels of LDL-C, HDL-C, and TG compared to patients who do not. 17 Although this prior research provides important information about the relationship between desirable lipid values and CV outcomes on a broad population basis, it does not provide detail into the same on the basis of the pattern of dyslipidemia at initial presentation.…”

“…[3][4][5] Previous research in diverse populations with elevated CV risk has demonstrated that multiple lipid abnormalities, characterized by combinations of undesired or nonoptimal values for LDL-C, HDL-C, non-HDL-C, and TG, are frequent. Further, simultaneous or combined achievement of desired or optimal levels for these lipid fractions is uncommon in routine clinical practice [13][14][15][16] in the United States. This observed high prevalence of multiple lipid abnormalities and low rates of combined lipid value achievement within desirable levels appears in part to be related to underutilization of guideline-recommended pharmacotherapy, in particular therapy targeted to HDL-C and TG abnormalities.…”