Changes in attainment of lipid goals by general practitioners and specialists in patients at high cardiovascular risk in Hungary during 2004-2008

Abstract

IntroductionLipid-lowering therapy should achieve target levels. We assessed the change of the achievement of targets and the mean low-density lipoprotein cholesterol (LDL-C) levels in high-risk Hungarian patients.Material and methodsSix studies performed with patients of general practitioners (GPs) and specialists between 2004 and 2008 were evaluated: 9,508 patients from GPs and 2809 from specialist practices (total 12,317).ResultsDuring this 4-year period the LDL-C level decreased by 0.73 mmol/l and the LDL-C goal achievement rate increased from 14 to 32% in patients treated by GPs. LDL-C showed a decrease of 0.48 mmol/l and the goal achievement rate changed from 20 to 43% in patients treated by specialists. In the majority of the patients not achieving the LDL-C goal (57% for specialists and 89% for GPs) there was no modification in the current therapy. In addition to emphasizing the priority of LDL-C lowering, we should also strive for residual risk reduction, which means raising high-density lipoprotein cholesterol (HDL-C) and lowering triglyceride levels. There was no significant improvement in HDL-C or triglyceride levels during the examined period.ConclusionMore attention needs to be paid to changing treatment of patients to achieve target levels.

Non-HDL cholesterol goal attainment and its relationship with triglyceride concentrations among diabetic subjects with cardiovascular disease: A nationwide survey of 2674 individuals in Hungary

“…These findings are in general agreement with previous data from Hungary [8,9,12]. By comparison, data from the EUROASPIRE surveys among patients with CHD showed a substantial 51% reduction in raised TC levels (4.5 mmol/l) from 1995 to 2007.…”

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“…The authors also specified that the use of combination therapy (e.g. statin plus ezetimibe) contributed to better goal achievement [13,14]. This interpretation is in agreement with communitybased studies that showed a significantly improved outcome in lipid targets following the addition of ezetimibe to a statin [15][16][17].…”

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“…At the end of the study the rate of achieving the 100 mg/dl LDL cholesterol target level was 58%, that of HDL cholesterol target level (40 mg/dl in males, 50 mg/dl in females) was 67% and in the case of triglyceride levels (150 mg/dl) 48%. The 58% in 100 mg/dl LDL cholesterol achievement rate is a very good result compared to that found in another observational study carried out in Hungary between 2004 and 2008, where among specialists the best result was 43% 4 . The 58% LDL cholesterol goal attainment in CORVUS is comparable to the results of the CEPHEUS study in which it varied between 40% and 68% in different European countries 5 .…”