Prevalence and predictors of lipid abnormalities in patients treated with statins in the UK general practice

To identify the prevalence and predictors of lipid abnormalities in statin-treated patients in the UK.

A retrospective cohort study was performed using the UK General Practice Research Database. Patients >or=35 years of age were included if they received first-ever statin between January 2000 and December 2004, received statins for at least 6 weeks, had >2 years of pre- and 1 year of post-statin initiation database history, received no concomitant lipid lowering drugs and had at least one complete lipid profile conducted within 1 year before and after initiating statins. Predictors of each lipid abnormality were determined using random effects logistic regression.

Within 1 year of statin initiation, 34.7%, 27.4%, 68.2% and 57.6% of patients did not reach optimal levels of TC, LDL-C, HDL-C and TG, respectively. Failure to attain TC goal was explained by smoking (odds ratio=1.13, 95% confidence interval [1.02-1.23]) and baseline TC >6.2mmol/L (5.01, [4.58-5.48]). Failure to attain LDL-C goal was associated with smoking (1.28, [1.14-1.43]), LDL-C >or=4.1 to <4.9mmol/L (2.72, [2.45-3.03]) and LDL-C >or=4.9mmol/L (8.54, [7.62-9.54]). High CHD risk was associated with low HDL-C in women at follow-up (1.94, [1.51-2.48]). Elevated TG was associated with baseline TG >or=2.2 to <5.6mmol/L (4.19, [3.81-4.59]), TG >or=5.6mmol/L (16.10, [3.67-70.57]), smoking (1.26, [1.11-1.42]) and hypertension (1.12, [1.01-1.23]).

While TC and LDL-C management appear appropriate in the UK, attainment of recommended levels of HDL-C and TG remains poor. The latter remains a concern, as poor attainment of recommended levels of HDL-C and TG is associated with high CHD risk in women, smoking and hypertension.