eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
Current issue Archive Manuscripts accepted About the journal Special issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
SCImago Journal & Country Rank
vol. 8

Lipid-lowering therapies and achievement of LDL-cholesterol targets

Manfredi Rizzo
Maciej Banach
Giuseppe Montalto
Dimitri P. Mikhailidis

Arch Med Sci 2012; 8, 4: 598-600
Online publish date: 2012/09/08
View full text
Get citation
JabRef, Mendeley
Papers, Reference Manager, RefWorks, Zotero
In the present issue of Archives of Medical Science, Mark et al. [1] report the results of a survey conducted last year in Hungary. This consisted of 1,626 adult patients with high cardiovascular (CV) risk, due to unstable angina (23%), peripheral artery disease (17%), previous myocardial infarction (34%), stroke (30%) or transient ischemic attack (17%). The main aim of the study was to assess the achievement of low density lipoprotein cholesterol (LDL-C) target levels, and to compare it with previous data from surveys performed by the same authors. The LDL-C target value in the present study was 2.6 mmol/l (100 mg/dl), in line with the recommendation of the Hungarian Cardiovascular Consensus Conference (2010) [2]; using this LDL-C target, the authors reported a 43.3% achievement rate. Furthermore, they noticed that the goal achievement rate was higher in patients followed by specialists (n = 1,152) vs. those followed by general practitioners (n = 474) (45% vs. 40%, respectively), but this difference did not reach significance [1].

The overall achievement rate was poor despite the high CV risk; this is a common problem in Europe and especially in Central and Eastern European countries [3]. As recently discussed [4], although the quality of lipid-lowering treatments has improved, in many European countries therapeutic inertia and a lack of sufficient knowledge regarding the best management of patients with lipid disorders remains an important problem [4, 5]. In addition, there is insufficient collaboration between specialists and primary care physicians [3-5]. We discuss potential problems of adherence to therapy in 3 different categories: patient-, prescriber- and drug-related factors.

Regarding patient-related factors, it is important to highlight the potential role of side effects and polypharmacy; indeed, patients at high CV risk usually need several drugs (e.g. anti-hypertensive, anti-diabetic and anti-platelet drugs). This was also true for the patients included in the Mark et al. study [1], where 46% had diabetes and 88% hypertension. Other patient-related factors include patient participation and understanding why the treatment is needed (awareness). This is linked to attendance and optimal frequency of follow-up visits [4-6].

Prescriber-related factors include the knowledge of LDL-C guideline targets, which have become more difficult to achieve over the years: this is a universal phenomenon that persisted...

View full text...
Quick links
© 2020 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe