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Statins Prescriptions and Lipid Levels in a Tertiary Public Hospital
André Schmidt1, Henrique Turin Moreira1, Gustavo Jardim Volpe1
1Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto (HCFMRP-USP), Ribeirão Preto, SP - Brasil.
Insights
A study of statin prescriptions in Brazil found that while widely used, they were not effectively controlling LDL-cholesterol levels. Many patients, particularly those with high LDL-cholesterol, may have undiagnosed familial hypercholesterolemia (FH).
Area of Science:
- Cardiology
- Lipidology
- Public Health
Background:
- New LDL-cholesterol-lowering drugs have increased interest in familial hypercholesterolemia (FH).
- Limited data exists on lipid profiles in Brazilian tertiary centers to estimate FH prevalence.
- Initial suspicion for FH is often based on LDL-cholesterol levels above 190 mg/dL.
Purpose of the Study:
- To evaluate the lipid profile, specifically total cholesterol and LDL-cholesterol.
- To assess ambulatory patients in a general tertiary public hospital in Brazil.
Main Methods:
- Retrospective study design.
- Comparison of statin prescriptions with lipid profile results.
- Statistical significance level set at 5%.
Main Results:
- Over 9,594 individuals received statin prescriptions; 51.5% were female, mean age 63.7 years.
- 18% of patients lacked recent LDL-cholesterol measurements; 2.4% had LDL-cholesterol ≥190 mg/dL despite statin use.
- Simvastatin was the most prescribed statin (77.6%).
Conclusions:
- Statin prescription is common in tertiary hospitals but shows limited success in achieving lipid control.
- A significant number of undiagnosed familial hypercholesterolemia (FH) cases are likely present.
- Proper diagnosis and treatment are crucial for patients with potential FH due to prognostic implications.
Background:
The development of a new class of medications that are highly capable of reducing LDL-cholesterol renewed the interest in the characterization of familial hypercholesterolemia patients. Nevertheless, little is known about the lipid profile of patients in tertiary healthcare centers in Brazil in order to better estimate the real occurrence of familial hypercholesterolemia, with initial suspect of LDL-cholesterol levels above 190 mg/d/L.
Objectives:
This study evaluated the lipid profile (total cholesterol and LDL-cholesterol) in ambulatory patients from a general tertiary public hospital.
Methods:
Retrospective study comparing prescriptions of statins and lipid profile results. The significance level was established in 5%.
Results:
In one year, 9,594 individuals received statin prescriptions, of whom 51.5% were females and the mean age was 63.7±12.9 years-old (18 to 100 years-old). Thirty-two medical specialties prescribed statins. Cardiology was responsible for 43% of the total. Nearly 15% of those patients with a prescription did not have a recent total cholesterol result and 1,746 (18%) did not have a recent LDL-cholesterol measurement. The occurrence of the latter between 130 and 190 mg/dL was present in 1,643 (17.1%) individuals, and 228 (2.4%) patients had an LDL-cholesterol ≥190mg/dL among those using statins at distinct doses. Only two statins were used: simvastatin and atorvastatin. The first was prescribed in 77.6% of the prescriptions.
Conclusion:
In this cross-sectional cohort at a tertiary general hospital, statins have been widely prescribed but with little success in achieving recognized levels of control. There is probably a significant number of FH individuals in this cohort that need to be properly diagnosed in order to receive adequate treatment due to its prognostic implications.
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