[Cholesterol is still high. So what do we do now? Treatment of uncontrolled hypercholesterolaemia over a year].
OBJECTIVE
To find the effectiveness of lipid-lowering treatment, based on normal clinical practice in primary care, on lipid control of patients with clear hypercholesterolaemia (HC). Design. Semi-experimental before-and-after intervention study.


METHODS
Urban health centre.


METHODS
187 patients known to have lipaemia, with total or LDL cCholesterol (cLDL) above 270 and 190 mg/dl, respectively.Intervention. Normal clinical practice for twelve months in nine primary care clinics.


METHODS
The lipid profile and lipid-lowering treatment were recorded at the start of the study and after twelve months. Lipid control (as a function of cLDL) was evaluated as optimal, acceptable or deficient, as a function of the cardiovascular risk, following the criteria of the Spanish Arteriosclerosis Society (1994).


RESULTS
In 27% of cases, no visit relating to HC was recorded by the patient s doctor. The number of patients treated with lipid-lowering drugs grew from 50 to 98 (27 vs 52%, p < 0,005), fundamentally at the expense of statin treatment. After twelve months, there were significant drops in the plasma concentration of cLDL (12%, 95%CI, 9 to 15%) and in the percentage of patients with deficient control, which fell from the initial 91% to 61% (p < 0.005), although only 16% reached optimal control.


CONCLUSIONS
After a year, under conditions of normal clinical practice, there was an increase in the use of lipid-lowering drugs and improvement in lipid control, though a bit over half the patients (61%) with clear hypercholesterolaemia maintained concentrations requiring treatment.
Tobias Ferrer
J
J
Centro de Atención Primaria PlaCa Catalunya. ABS Manresa-2. Manresa, Barcelona, Spain. jtobias@medynet.com
Sanjuán Cortés
R
R
Fàbrega Camprubí
M
M
Bonet Selga
L
L
Roses Circuns
C
C
Boquer Arnó
J
J
D002784:Cholesterol / Q000097:blood*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D000960:Hypolipidemic Agents; D002784:Cholesterol