Association between Prescription and Control Status of Dyslipidemia and Hypertension among Japanese Patients with Diabetes

Abstract

Aims: The proper management of atherosclerotic risk factors (ARFs) and attainment of target levels (TLs) for ARFs are crucial in preventing atherosclerotic cardiovascular disease (ASCVD). In this study, utilizing data from the “Specific Health Check and Guidance in Japan,” which was conducted from 2008 to 2011, we examined TL attainment status of low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) and prescription status of dyslipidemia and hypertension in patients with diabetes undergoing medical treatment, and analyzed the factors that affected prescription status.Methods: Subjects receiving medical treatment for diabetes were selected from the database. Subjects were classified by prescription status for dyslipidemia and hypertension, and TL attainment status was assessed for each ARF.Results: The percentage of subjects who did not attain TLs and were not under medication was higher for LDL-C than for BP. The un-prescribed rates among non-TL-attained subjects were 60%–75% for LDL-C, and around 30%–40% for BP. The un-prescribed rates to those who were qualified for prescription therapy were also higher for LDL-C than for BP. Logistic regression analyses revealed that the subjects who were prescribed for dyslipidemia had the following characteristics compared with the un-prescribed non-TL-attained subjects: older age, higher body mass index, lower estimated glomerular filtration rate, previous heart or cerebrovascular disease, and higher medication rate for other ARFs.Conclusions: The present study revealed that, in Japan, the adequate prescription rate for dyslipidemia was lower than that for hypertension in patients with diabetes, suggesting the proper prescription therapy for dyslipidemia should be pursued to further prevent ASCVD.

Risk Stratification for Cardiovascular Disease Based on Prior Coronary Artery Disease, Cerebrovascular Disease and Diabetes Mellitus

“…We previously reported that SBP was the most important modi able risk factor for subsequent CVD regardless of glucose abnormality [19]. Blood pressure targets were shown to be more di cult to achieve than cholesterol targets in diabetic patients [23,24]. While a meta-analysis showed that the optimal SBP for stroke prevention was < 130 mmHg [25], the mean baseline SBP was 132 mmHg in the CAD-/CVD+/DM group in our study, which did not reach the target level.…”