Application of simple lipid treatment goals in patients with atherosclerotic disease.
OBJECTIVE
In this multicentre observational study the "5-4-3-2-1" guideline (total cholesterol < 5.0 mmol/L, the ratio of total to high-density lipoprotein cholesterol < 4, low-density lipoprotein cholesterol < 3.0 mmol/L, triglycerides < 2.0 mmol/L and high-density lipoprotein cholesterol > 1.0 mmol/L) was compared with the new European recommendations (total cholesterol < 5.0 mmol/L and low-density lipoprotein cholesterol < 3.0 mmol/L) ("5-3") and a treatment criterion of low-density lipoprotein cholesterol < 3.0 mmol/L and triglycerides < 1.5 mmol/L ("3-1.5"), as patients with triglycerides > 1.5 mmol/L may have an increased risk of premature cardiovascular disease.


RESULTS
In 1997/98, 2134 patients in general practice with established atherosclerotic disease on a lipid-lowering therapy were monitored. The "5-4-3-2-1" guideline was met in 19.2% and the "5-3" guideline in 36.2% and 22.5% fulfilled the "3-1.5" criterion. Our data showed a good conformity between the "5-4-3-2-1" guideline and the "3-1.5" criterion. Of the patients who achieved the "5-3" guideline approximately 50% still had unfavourable values of HDL-cholesterol and TG, while only 15% of those who fulfilled the "3-1.5" criterion had HDL-cholesterol < or = 1.0 mmol/L.


CONCLUSIONS
A treatment goal of LDL-cholesterol < 3.0 mmol/L and fasting TG < 1.5 mmol/L markedly raised the proportion of patients with desirable levels of HDL-cholesterol and the ratio of total cholesterol to HDL-cholesterol and should be recommended in secondary prevention, especially in diabetic patients.
Lipid Clinic, Rikshospitalet, Oslo, Norway.
A
A
Svilaas
H K
HK
Walsöe
L
L
Ose
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D014280:Triglycerides