Prospective, noninterventional, uncontrolled, open-chart, pharmacoepidemiologic study of prescribing patterns for lipid-lowering drugs at a tertiary care teaching hospital in North India.
BACKGROUND
The guidelines for management of dyslipidemia released by the US National Cholesterol Education Program (NCEP) have been questioned for their relevance in the South Asian Indian populations because these populations are reported to have significantly different lipoprotein parameters and atherogenic risk factors than Western populations.


OBJECTIVE
The aim of this study was to determine current prescribing patterns for lipid-lowering drugs (LLDs) adopted by physicians in North India.


METHODS
This prospective, noninterventional, uncontrolled, open-chart, pharmacoepidemiologic study was conducted from June 2000 to August 2000 at a tertiary care hospital in North India and included 200 dyslipidemic patients. The pattern of prescribing LLDs was recorded, along with the serum levels of lipid parameters-total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and lipoprotein(a) (Lp[a])-at the time of initiating LLD therapy and compared with the 1993 NCEP-II therapeutic guidelines for dyslipidemia management.


RESULTS
The mean (SD) levels of lipid parameters in the study population were as follows: TC, 223.2 (21.5) mg/dL; TG, 258.4 (61.3) mg/dL; LDL-C, 131.6 (26.5) mg/dL; HDL-C, 39.8 (8.9) mg/dL; and Lp(a), 44.8 (26.8) mg/dL. The LLDs prescribed were fibrates (53.5%) and statins (46.5%). Forty percent of patients prescribed LLDs did not meet the NCEP-II criteria for initiation of LLD therapy.


CONCLUSIONS
Considerable differences in prescribing patterns of LLDs were observed compared with the then-prevalent NCEP-II guidelines. However, due to the abnormally high serum Lp(a) levels present in the average dyslipidemia profile in South Asian Indian populations, this pattern was in accordance with the specific recommendations made for these populations, as well as with the 2001 NCEP-III guidelines.
Goyal
Pankaj
P
Department of Pharmacology, Government Medical College, Amritsar, Punjab, India. drpankajgoyal@rediffmail.com
Sharma
Geeta
G
Bal
Baljinderpal S
BS
Singh
Jatinder
J
Singh
Jagjit
J
Randhawa
Gurpreet Kaur
GK
Pandhi
Shaloo
S
Sharma
Rohit
R
D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood; D048909:Diabetes Complications; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D015444:Exercise; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D006949:Hyperlipidemias / Q000178:diet therapy / Q000188:drug therapy* / Q000453:epidemiology; D006973:Hypertension / Q000150:complications; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
D000960:Hypolipidemic Agents; D014280:Triglycerides; D002784:Cholesterol