Impact of lipid‐lowering therapy on the prevalence of dyslipidaemia in patients at high‐risk of cardiovascular events in UK primary care – a retrospective database study

Abstract

SummaryAimsTo estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice.MethodsThe PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines.ResultsAt the index date, 98% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2% (sub-group range: 11.0–22.9%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8% to 68.9%, and from 99.2% to 68.7%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0% to 26.9%, whereas that of low HDL-C levels increased, from 16.6% to 18.0%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels.ConclusionsDespite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.

The prevalence of dislipidemia and its relation to other risk factors: a nationwide survey of Lithuania

“…Dyslipidemia may be related to other diseases (secondary dyslipidemia) or to the interaction between genetic predisposition and environmental factors [2]. Treatment of dyslipidemia, particularly high levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), is, therefore, a central strategy in the prevention of CVD [7].…”

Drug Treatment of Hyperlipidemia in Chinese Patients: Focus on the Use of Simvastatin and Ezetimibe Alone and in Combination

“…Studies in other countries have shown that the poor LDL-C control rate for high-risk patients treated in general practice is a global problem [31][32][33]. In South Africa, the control rate for very high-risk patients was reported to be only 26.5%.…”

Association of blood glucose and lipid levels with complete blood count indices to establish a regression model

“…It has been estimated that there was 382 million people with type II diabetes mellitus in 2013, while the prevalence of diabetes is estimated to increase by 55% in 2035, reaching a total number of 592 million (1). Dyslipidemia, which is defined by elevated total cholesterol (CHO), triglyceride (TG) and/or low-density lipoprotein cholesterol (LDL-C) levels, and non-optimal levels of high-density lipoprotein cholesterol (HDL-C), is particularly prevalent worldwide (2)(3)(4).…”