Lipid Management in a Japanese Community:Attainment Rate of Target Set by the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012

Abstract

Aim: The Japan Atherosclerosis Society (JAS) guidelines for the prevention of atherosclerotic diseases 2012 (JAS2012) proposed lipid management targets; however, less data is available regarding the attainment rates of each target in community-based settings. Therefore, we assessed the attainment rates of lipid management targets among subjects who underwent Japanese specific health checkups.Methods: A total of 85,716 subjects (male = 29,282, 34.2%) aged 40–74 years who underwent specific health checkups from 2012 to 2014 in Kanazawa city, Japan, were included in this study. We evaluated the attainment rates of the lipid management targets according to the JAS2012 guideline and investigated the clinical characteristics of the subjects without achieving the targets.Results: The target for LDL cholesterol (LDL-C) was the least attained in all risk categories, 89, 72, 50, and 34% for category I, II, III, and secondary prevention, respectively, in 2014. In addition, these rates inversely correlated with the grade of risk categories (p-value for trends <0.001). Attainment rate of the LDL-C target in the suspected chronic kidney disease (CKD) group was significantly lower than in the groups with diabetes, stroke, or absolute risk in category III (49.2, 60.3, 63.5, 54.4%, respectively, p-value <0.001 for each). Moreover, the attainment rate of the LDL-C target was significantly lower in subjects that did not receive lipid-lowering therapy than in those who received it in the secondary prevention (27.7 and 40.6%, respectively, p-value <0.001).Conclusions: Lipid management is inadequate in community-based settings, particularly, in subjects with CKD and secondary prevention.

The Association between Glomerular Filtration Rate Estimated on Admission and Acute Stroke Outcome: The Shiga Stroke Registry

“…Promotion and preventive measures to manage cardiovascular disease risk factors in community level, specifically in renal dysfunction patients, is of no less importance. A recent study investigating lipid management targets in Japan showed inadequate attainment rates in the population, raising alarm for its improvement 43 ) .…”

“…Serum creatinine was only measured on admission and in individual centers, thereby influencing its accuracy. Furthermore, admission NIHSS, a strong predictor of stroke outcome 43 ) , was not incorporated due to its high rate of missing data. However, we perceive this issue to be overcome by using JCS, a Japanese-based consciousness level score developed in the same year as the Glasgow Coma Scale, which has been proven to have good predictability of stroke outcome 22 ) .…”

Evidence-Based Carotid Interventions for Stroke Prevention: State-of-the-art Review

“…83) . Insight may be gained from country-specific studies, for example a Japanese single-centred observational study demonstrated remarkably low periprocedural stroke rates (0.68%) and annual stroke rates (0.64%) for CEA in asymptomatic patients.…”

The Relationship of Dietary Cholesterol with Serum Low-Density Lipoprotein Cholesterol and Confounding by Reverse Causality: The INTERLIPID Study

“…Tests were also performed to clarify whether the coefficients differed between the employed and the others. 36,[41][42][43][44] . Employed people in a company, particularly in large-scale companies, have more opportunities to undergo medical health check-ups and obtain health information than the others 45) .…”