title: Low adherence of General Practitioners to National Cholesterol Education Program guidelines for the management of hyperlipidaemia.
abstract: Aim of our study was to assess adherence to the National Cholesterol Education Program Adult-Treatment Panel II (NCEP-ATP II) in patients cared for by General Practitioners (GPs) in an Italian community. The design of the work was cross-sectional cohort study; the base was an unselected cohort of 1,168 patients cared for by GPs and screened at our lipid clinic in 1994-1995 in the Province of Turin (Italy). Blood samples were collected after 12-hr fast to measure plasma levels of total cholesterol, triglycerides, HDL-cholesterol, glucose and thyroid-stimulating hormone (TSH). LDL-cholesterol was calculated using Friedewald's formula. In patients with body mass index (BMI) >30 kg/m2, an oral glucose tolerance test was performed. Blood pressure was measured in all patients, and a baseline ECG or a stress test was performed in those with unknown cardiovascular disease (CVD), then they were classified following the NCEP-ATP II criteria. Primary hyperlipidaemia accounted for 86.9% of the cohort with most patients requiring pharmacological treatment; in 34.4% of the patients, LDL-cholesterol values were > or = 6.46 mmol/l (250 mg/dl) and in 23.7% with established CVD, LDL-cholesterol levels were > or = 5.68 mmol/l (220 mg/dl). In only 7.3% of patients the NCEP treatment goals were achieved, with 1.3% among those in secondary prevention. We observed great discrepancies between clinical practice and international recommendations for the management of hyperlipidaemia.
authors: Department of Internal Medicine, University of Turin, Torino, Italy.
authors: P
authors: P
authors: Fornengo
authors: G
authors: G
authors: Bruno
authors: A
authors: A
authors: De Salvia
authors: R
authors: R
authors: Arcari
authors: E
authors: E
authors: Pisu
authors: G
authors: G
authors: Pagano
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000592:standards; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D012907:Smoking
chemical_list: D008078:Cholesterol, LDL; D002784:Cholesterol