Related Experiment Video
Updated: May 13, 2026
Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Attainment of goal and normalized lipid levels with lipid-modifying therapy in Malaysia
Tun-Ying Hsu1, Diana Chirovsky, Foong Ming Moy
1Merck Sharp & Dohme (I.A.) Corp., Singapore Branch, Singapore.
Insights
Lipid-modifying therapy in Malaysia shows suboptimal low-density lipoprotein cholesterol (LDL-C) goal attainment. Many patients also fail to reach normal high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, indicating a need for comprehensive lipid management.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Background:
- Low-density lipoprotein cholesterol (LDL-C) is a primary target for coronary heart disease (CHD) risk reduction.
- High-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) are also recognized as significant CHD risk factors.
- Effective lipid management is crucial for preventing cardiovascular events.
Purpose of the Study:
- To assess the achievement of lipid goals (LDL-C, HDL-C, TG) in Malaysian patients undergoing lipid-modifying therapy (LMT).
- To evaluate the effectiveness of LMT in an ethnically diverse patient population in Malaysia.
- To identify the proportion of patients with multiple abnormal lipid levels before and after LMT.
Main Methods:
- Retrospective analysis of longitudinal medical records of 607 Malaysian patients (≥35 years) initiated on LMT (2004-2006).
- Inclusion criteria required lipid panels 12 months pre- and post-LMT initiation.
- Defined LDL-C goals and normal HDL-C/TG levels based on Malaysian Clinical Practice Guidelines.
Main Results:
- Before LMT, 89% had elevated LDL-C, 37% low HDL-C, 56% high TG, and 62% had ≥2 abnormal lipid levels.
- Despite LMT (primarily statins), 60% still had elevated LDL-C, 37% low HDL-C, and 40% high TG.
- A significant 44% of patients continued to have at least two abnormal lipid levels post-therapy.
Conclusions:
- Lipid-modifying therapy, predominantly statins, yields suboptimal LDL-C goal attainment in Malaysian patients.
- A substantial number of patients fail to achieve normal HDL-C and TG levels.
- A comprehensive approach targeting all three lipid parameters is recommended for improved cardiovascular risk management.
Background:
Although LDL-C is the primary lipid target for coronary heart disease (CHD) risk reduction, HDL-C and triglycerides (TG) have also emerged as CHD risk factors.
Objective:
The objective of this study was to evaluate goal/normal lipid level attainment after lipid-modifying therapy (LMT) in an ethnically diverse sample of patients in Malaysia.
Methods:
Retrospective, longitudinal data were collected from the medical records of patients aged ≥35 years in whom LMT was initiated between January 2004 and December 2006. Eligible patients had records of full lipid panels 12 months before and after the start of therapy. LDL-C goals and normal levels of HDL-C and TG were defined as per the Clinical Practice Guidelines on Management of Dyslipidemia (4th edition), Malaysia. A subgroup of patients at high risk for CHD events (established CHD, diabetes but no CHD, or a 10-year history of Framingham risk score ≥20%) was also studied.
Results:
Among 607 eligible patients (mean age, 57.1 years; 40% male), 89% had elevated LDL-C, 37% had low HDL-C, 56% had elevated TG, and 62% had ≥2 abnormal lipid levels before LMT. Despite therapy (87% statins only), 60% had elevated LDL-C, 37% had low HDL-C, 40% had elevated TG, and 44% continued to have ≥2 abnormal lipid levels.
Conclusions:
In this longitudinal study of Malaysian patients treated with lipid-modifying therapy, primarily using statins, attainment of LDL-C goal is suboptimal. Furthermore, a large proportion of patients do not achieve normal levels of HDL-C and TG. Therefore, patients may benefit from a more comprehensive approach to lipid management that treats all 3 lipid risk factors, as suggested in clinical guidelines.
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:26Atherosclerosis III: Management
01:24Overview of Lipid Metabolism
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
01:26Coronary Artery Disease IV: Preventive Measures
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:24Lipid Absorption
These breakdown products bind with bile salts and lecithin to form micelles, which quickly pass between microvilli to come in close contact with the apical...