title: Cardiovascular risk factors and recommended lipid goals attainment among patients referred in a tertiary care lipid clinic.
abstract: BACKGROUND
  Many adults are not at recommended lipid levels and the extent of treatment of dyslipidemia remains poor. We investigated the burden of cardiovascular risk and the distance of lipid fractions from the recommended targets by statin therapy and risk status in patients referred to a tertiary care lipid clinic.
  
  
  METHODS
  Assessment of cardiovascular risk factors was performed in 1657 patients, mostly dyslipidemics, referred by family physicians to our Lipid Clinic, 393 patients being under statin therapy. The shortfall of lipid fractions from the National Cholesterol Education Program Adult Treatment Panel-III (NCEP ATP-III) recommended goals was evaluated.
  
  
  RESULTS
  A high prevalence of cardiovascular risk factors was found. LDL cholesterol target was reached by 20% and 45% of untreated and statin treated patients, whereas non-HDL cholesterol target by 13% and 45% of untreated and statin treated patients, respectively. LDL cholesterol was over the goal by 27% in untreated patients and by 25% in statin treated patients. More than 40% and 65% statin treated patients were taking either a low statin dose or statins with low-to-moderate LDL cholesterol lowering efficacy (<30%). A decrease in the proportion of patients at target and greater shortfalls from recommended goals were found from low to high risk categories.
  
  
  CONCLUSIONS
  The shortfall in reaching lipid targets, particularly among high risk statin untreated patients, may be partly explained by delayed or even inadequate lipid lowering therapy. Shortfalls in reaching the targets are not necessarily high and might be possibly managed at a primary care level.
authors.affiliation: Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, and Hospital Santa Maria della Misericordia, Piazzale Menghini, Perugia, Italy. mpirro@unipg.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Pirro
authors.forename: Rosaria
authors.initials: R
authors.lastname: Del Giorno
authors.forename: Graziana
authors.initials: G
authors.lastname: Lupattelli
authors.forename: Massimo Raffaele
authors.initials: MR
authors.lastname: Mannarino
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Roscini
authors.forename: Domenico
authors.initials: D
authors.lastname: Covelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Schillaci
authors.forename: Leonella
authors.initials: L
authors.lastname: Pasqualini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bagaglia
authors.forename: Donatella
authors.initials: D
authors.lastname: Siepi
authors.forename: Elmo
authors.initials: E
authors.lastname: Mannarino
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids