A contemporary cross-sectional study on dyslipidemia management, cardiovascular risk status, and patients' quality of life in Greece: The CHALLENGE study

Alexopoulos, Dimitrios; Anastasiou-Nana, Maria; Elisaf, Moses; Liberopoulos, Evangelos N.; Rallidis, Lοukianos S.; Davos, Constantinos H.; Moulis, Alexandros; Nikas, Nikos; Zacharis, E.; Vardas, Panos

doi:10.1016/j.ijcard.2016.05.003

Cited by 5 publications

(3 citation statements)

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“…Achievement of the more aggressive target of \ 1.8 mmol/L, as recommended in ESC/EAS 2016 guidelines [1] for individuals at very high risk (established CVD or SCORE C 10%), was especially poor, at less than 19% in both risk groups. The proportions of patients reaching the target of \ 2.5 mmol/L applicable to the FH and SCORE 5-10% risk groups were also suboptimal reporting LDL-C goal achievement stratified by high risk and very high risk [48][49][50][51]. LDL-C low-density lipoprotein cholesterol, HR high risk, VHR very high risk (15% and 46%, respectively).…”

Section: Discussionmentioning

confidence: 97%

Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review

et al. 2020

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Objective: Assess achievement of low-density lipoprotein cholesterol (LDL-C) targets in European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Design: Systematic literature review. Data Sources: Medline, EMBASE, Cumulated Index to Nursing and Allied Health Literature. Eligibility Criteria: Observational studies reporting LDL-C levels/target attainment, measured between 1 August 2006 to 31 August 2017, in European adults with established cardiovascular disease (CVD), diabetes with target organ damage, familial hypercholesterolaemia (FH) or 10-year risk of fatal CVD C 5% (assessed by Systematic Coronary Risk Evaluation [SCORE]). Data Extraction and Synthesis: Two reviewers independently extracted relevant studies and Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.11908161.

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Section: Discussionmentioning

confidence: 97%

Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review

et al. 2020

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“…DYSIS II applied the more stringent cutoff of < 70 mg/dl recommended by the 2011 ESC guidelines [2] for patients at very high risk, and therefore much lower rates of attainment were observed. In other studies applying the < 70 mg/dl LDL-C target value to Greek patients, attainment rates were 10.0% in patients with CVD or diabetes and newly treated with LLT for a median of 3 months [15]; 14.7% among patients on LLT in the Centralized Pan-European Survey on the Undertreatment of Hypercholesterolemia (CEPHEUS) [20]; 16.2% and 18.2%, respectively, in ACS patients upon admission to a hospital and 6 months after discharge [10, 21]; 25% among very high risk adult outpatients at a lipid treatment clinic [14], and 15.5% among very high risk patients in the CHALLENGE study [22]. Thus, LDL-C target value attainment in CHD and ACS patients in DYSIS II (25% for both) was at the high end of the range observed to date in very high risk Greek patients.…”

Section: Discussionmentioning

confidence: 99%

Attainment of cholesterol target values in Greece: results from the Dyslipidemia International Study II

Liberopoulos

Rallidis

Spanoudi³

et al. 2019

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Introduction Current European guidelines recommend treatment with lipid-lowering therapy (LLT) to a low-density lipoprotein cholesterol (LDL-C) target of < 70 mg/dl for patients at very high risk. LDL-C target attainment and use of LLTs in these patients in Greece is not known. Material and methods The Dyslipidemia International Study (DYSIS) II was a multicenter observational study. The coronary heart disease (CHD) cohort was divided into two groups based on treatment status (on LLT for ≥ 3 months or not on LLT). The acute coronary syndrome (ACS) cohort was evaluated at the time of admission and again 120 ±15 days after admission. Results In the CHD cohort ( n = 499), 457 (91.6%) patients were on LLT. The LDL-C target value was attained by 26.5% of LLT users. Statin monotherapy was used by 77.5% of treated patients, with a mean ± SD atorvastatin dose equivalent of 24 ±16 mg/day. In the ACS cohort ( n = 200), 159 (79.5%) patients were on LLT at admission. Mean ± SD LDL-C levels were 108 ±40 mg/dl at admission and 86 ±25 mg/dl at follow-up. LDL-C target value attainment rates were 16.2% at admission and 25.0% at follow-up. At admission, statin monotherapy was used by 86.8% of treated patients. The mean ± SD atorvastatin dose equivalent increased from 20 ±14 mg/day at admission to 29 ±15 mg/day at follow-up. The statin dose was associated with higher odds of LDL-C target value attainment (OR = 1.05, 95% CI: 1.02–1.08). Conclusions The LDL-C target attainment by very high risk patients in Greece is suboptimal. Increasing the statin dose or combining it with non-statins may improve target value attainment.

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“…For example, the traditional Mediterranean diet which is habitual among the Greek population has been associated with significant reductions in total mortality and incidence of cardiovascular events with improvements in overall health status [ 12 , 13 ]. Official guidelines and treatment practice, ranging from prescribed medications to lifestyle and dietary instructions, often consider and adjust for local population characteristics to meet diverse needs and to improve health outcomes [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing forgetfulness and polypharmacy and their impact on health-related quality of life among patients with hypertension and dyslipidemia in Greece during the COVID-19 pandemic

et al. 2021

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Purpose We estimate the association between forgetfulness to take medications as prescribed and polypharmacy and health-related quality of life (HRQoL) among a cohort of patients with hypertension, dyslipidemia or both in Greece during the COVID-19 pandemic. Methods A telephone survey of 1018 randomly selected adults was conducted in Greece in June 2020. Participants were included in the survey, if they (a) had a diagnosis of hypertension, dyslipidemia or both and (b) were on prescription treatment for these conditions. HRQoL was calculated using the short form (SF) -12 Patient Questionnaire. A multivariable generalized linear regression model (GLM) was used to estimate the association between forgetfulness and polypharmacy and HRQoL, controlling for sociodemographic and health-related covariates. Results Overall, 351 respondents met the inclusion criteria, of whom 28 did not fully complete the questionnaire (response rate: 92%, n = 323). Of those, 37% were diagnosed with hypertension only, 28% with dyslipidemia only, and 35% with both. Most reported good to average physical (64.1%) and mental health (48.6%). Overall, 25% indicated that they sometimes forget to take their prescribed medications, and 12% took two or more pills multiple times daily. Total HRQoL score was 68.9% (s.d. = 18.0%). About 10% of participants reported paying less attention to their healthcare condition during the pandemic. Estimates of multivariable analyses indicated a negative association between forgetfulness (− 9%, adjusted β: − 0.047, 95% confidence interval − 0.089 to − 0.005, p = 0.029), taking two or more pills multiple times daily compared to one pill once a day (− 16%, adjusted β: − 0.068, 95% confidence interval − 0.129 to − 0.008, p = 0.028) and total HRQoL. Conclusion Our results suggest that among adult patients with hypertension, dyslipidemia or both in Greece, those who forget to take their medications and those with more complex treatment regimens had lower HRQoL. Such patients merit special attention and require targeted approaches by healthcare providers to improve treatment compliance and health outcomes.

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A contemporary cross-sectional study on dyslipidemia management, cardiovascular risk status, and patients' quality of life in Greece: The CHALLENGE study

Cited by 5 publications

References 24 publications

Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review

Proportion of High-Risk/Very High-Risk Patients in Europe with Low-Density Lipoprotein Cholesterol at Target According to European Guidelines: A Systematic Review

Attainment of cholesterol target values in Greece: results from the Dyslipidemia International Study II

Assessing forgetfulness and polypharmacy and their impact on health-related quality of life among patients with hypertension and dyslipidemia in Greece during the COVID-19 pandemic

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