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Published on: November 10, 2017

[Lipid lowering goals in high risk and very high cardiovascular risk patients: a reasonable challenge?]

A Gómez-Belda1, E Rodilla, C González

  • 1Unidades de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital de Sagunto, Valencia. España.

Revista Clinica Espanola
|October 18, 2006
PubMed

Insights

New National Cholesterol Education Program (NCEP) guidelines set lower LDL-c targets. Few patients with very high vascular risk achieve these goals, even with aggressive treatment.

Area of Science:

  • Cardiology
  • Lipid Metabolism
  • Public Health

Background:

  • Recent NCEP guidelines recommend lower low-density lipoprotein cholesterol (LDL-c) targets for patients at very high vascular risk.
  • Assessing adherence to these updated therapeutic targets is crucial for cardiovascular risk management.

Purpose of the Study:

  • To evaluate the compliance rate with the updated NCEP therapeutic targets for LDL-c in patients with high and very high vascular risk.
  • To determine the proportion of patients achieving target LDL-c levels under current treatment regimens.

Main Methods:

  • A descriptive, cross-sectional study was conducted on 836 patients from a cardiovascular clinic.
  • Low-density lipoprotein cholesterol (LDL-c) levels were calculated, and targets were set according to the NCEP ATP III update.
  • Patient data included treatment status (statins, other lipid-lowering drugs) and achievement of LDL-c goals.

Main Results:

  • Only 38% of high-risk (HR) and 15% of very high-risk (VHR) patients achieved their target LDL-c levels.
  • Despite statin treatment (45% HR, 67% VHR), goal attainment was low.
  • Even with maximum statin doses and additional lipid-lowering drugs, 31% of HR and 51% of VHR patients could not reach LDL-c targets.

Conclusions:

  • A significant gap exists in achieving NCEP-recommended LDL-c targets, particularly for very high-risk patients (only 15% achieved goals).
  • Aggressive pharmacological interventions, including maximum statin doses combined with other agents, are insufficient for a substantial portion of patients to reach LDL-c goals (<70 mg/dl).
  • Further strategies may be needed to optimize lipid management in high-risk populations.
Abstract

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