eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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vol. 6

Are we getting to lipid targets in real life?

Niki Katsiki
Dimitri P. Mikhailidis
Vasilis G. Athyros
Apostolos I. Hatzitolios
Asterios Karagiannis
Maciej Banach

Arch Med Sci 2010; 6, 5: 639-641
Online publish date: 2010/10/27
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In this issue of Archives of Medical Science a Hungarian group reports on lipid goal achievement in 12,317 high risk patients [1]. This analysis considers the treatment of dyslipidemia between 2004 and 2008 and also compares the performance of general practitioners (GPs) and specialists (9,508 and 2,809 patients, respectively). During this period the percentage of patients “on target” for low density lipoprotein-cholesterol (LDL-C) increased from 14% to 32% and 20% to 43% when treated by GPs and specialists, respectively. In contrast, there was no significant improvement in high density lipoprotein-cholesterol (HDL-C) or triglyceride (TG) levels. The conclusion was that “more attention needs to be paid to changing treatment of patients to achieve target levels”. This includes an increased use of combination therapy.
The authors [1] attribute the improvement in lipid management between 2004 and 2008 to the application of up-to-date consensus recom­men­dations. More specifically, information was provided to physicians via journals, scientific meetings and country-level coordinators.
We previously conducted 4 pilot best-practice implementation enhancement programmes aimed at improving risk factor control [2-5]. Physicians from Hospitals or Health Centres recruited patients with metabolic syndrome (MetS) (628 patients, the SAGE-METS [Standardized arrangement for a guideline driven treatment of the metabolic syndrome] study) [2], diabetes mellitus (DM) (578 patients, the INDEED [Initiative for a new Diabetes therapeutic approach in a Mediterranean country] study) [3], hypertension (697 patients, the IMPULSION [Implementation of guidelines for the management of arterial hypertension] study) [4] or dyslipidemia (1127 patients, the IMPROVE-dyslipidemia [Implementation of strategy for the management of overt dyslipidemia] study) [5].
Participating physicians attended educational programmes related to current guidelines for MetS, DM, hypertension, dyslipidemia, overt cardiovascular disease (CVD), obesity and nutrition [2-5]. The physicians were motivated to participate as part of their continuing medical education program. Patients were also motivated by supplying them with a brochure that included instructions to help them achieve treatment goals.
The prevalence of dyslipidemia was reduced from 79 to 24% in the SAGE-METS study [2], from 76 to 12% in the INDEED study [3], from 59.7 to 53.6% in the IMPULSION study [4] and from 100 to 21%...

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