How many patients need statin treatment in a low-cardiovascular-risk country? Low-density lipoprotein-cholesterol target and distance from target distribution in an Italian cohort.
OBJECTIVE
To assess cardiovascular risk distribution, distribution of individual low-density lipoprotein (LDL)-cholesterol target and distance of LDL cholesterol from the target in a representative sample of the Italian population.


RESULTS
Cross-sectional, population-based study of a representative sample of the Italian adult population, comprising 5458 individuals (from 40 to 79 years of age, both sexes) from general practices in Italy. Of the subjects, 65.2% were in the low-cardiovascular-risk class, whereas 10.5%, 18.3% and 6.0% had moderate, high, and very high cardiovascular risk profiles, respectively; 8.2% of the subjects were treated with statins at enrolment. Of the cohort, 68.3% displayed LDL-cholesterol values below their LDL target, as calculated according to their individual risk profile. Among the 31.7% 'not at target', 42.3% were ≤ 15%, 44.3% were between 15% and 40% and 13.4% were >40% over their LDL target.


CONCLUSIONS
About two-thirds of adults in a low-cardiovascular-risk country, such as Italy, have LDL-cholesterol levels 'at target', as defined in current guidelines. Accordingly, the remaining subjects require a lifestyle or pharmacological intervention to reach their target; 24% of the total cohort, in detail, need to be treated with a statin (or to continue the prescribed statin treatment) to reach the proper LDL target. This type of data analysis might help to optimise resource allocation in preventive medicine.
Poli
A
A
Epidemiology and Preventive Pharmacology Centre, SEFAP, Department of Pharmacological Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy. poli@nutrition-foundation.it
Tragni
E
E
Casula
M
M
Filippi
A
A
Diotti
R
R
Brignoli
O
O
Cricelli
C
C
Catapano
A L
AL
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D008875:Middle Aged
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors