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Published on: November 10, 2017
Current status of lipid management of hypertensive patients
Koichi Matsubara1, Yasutaka Yamamoto, Kazuhiko Sonoyama
1Department of Cardiovascular Medicine, Tottori University Hospital, 36-1 Nishi-machi, Yonago 683-8504, Japan.
Insights
Lipid management in hypertensive patients is often insufficient, with low achievement rates for target cholesterol levels despite high treatment rates, especially in patients with coronary heart disease.
Area of Science:
- Cardiology
- Metabolic Disorders
- Public Health
Background:
- Hypertension management requires concurrent lipid control to mitigate cardiovascular disease risk.
- Assessing current lipid management practices in hypertensive individuals is crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the quality of lipid management in hypertensive patients based on established guidelines.
- To determine the prevalence of hyperlipidemia and the effectiveness of lipid-lowering therapies in this population.
Main Methods:
- Retrospective review of 830 hypertensive patients' profiles.
- Assessment of lipid management quality using the 1997 Japan Atherosclerosis Society (JAS) guidelines.
- Analysis of hyperlipidemia prevalence, drug utilization, and target level achievement.
Main Results:
- Hyperlipidemia was diagnosed in 45.2% of hypertensives and 56.6% of patients with coronary heart disease (category C).
- Lipid-lowering drugs were used in 63.5% of hypercholesterolemic patients, with statins being predominant (>80%).
- Only 39.4% of all hypertensives and 17.1% of category C patients achieved target cholesterol levels.
Conclusions:
- Current lipid management strategies for hypertensive patients are insufficient, evidenced by low target achievement rates.
- Despite high treatment rates, particularly with statins, therapeutic goals for cholesterol levels remain unmet for many patients.
- Patients with coronary heart disease (category C) exhibit the most significant deficits in achieving lipid management targets.
Abstract:
Hypertensives, in addition to requiring strict blood pressure control, need lipid management to prevent cardiovascular disease. To assess the current status of lipid management of hypertensives, we reviewed the profiles of 830 hypertensives. The quality of lipid management was assessed using the Japan Atherosclerosis Society (JAS) Guideline for Diagnosis and Treatment of Hyperlipidemia in Japanese Adults announced in 1997. Hyperlipidemia was diagnosed in 45.2% of hypertensives and in 56.6% of patients in category C (a group of patients with coronary heart disease). Lipid-lowering drugs were used in 63.5% of all hypercholesterolemic patients and in 78.1% of category C patients. Statins were administered to more than 80% of hypercholesterolemic patients. Only 39.4% of hypertensives achieved the target total cholesterol level and only a very small percentage (17.1%) of patients in category C reached the target levels. The elderly hypertensives were the single largest group (42.2% of all hypertensives) in this study population, and the target cholesterol level for this group has been elevated from 200 mg/dl to 220 mg/dl in the JAS Guidelines for Diagnosis and Treatment of Atherosclerotic Cardiovascular Diseases announced in 2002 (new guidelines). In conclusion, in hypertensives requiring lipid management, the lipid-lowering approach appeared insufficient, as the target achievement rate was relatively low despite a high treatment rate. This was most marked for patients in category C.
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