title: Attainment of normal lipid levels among patients on lipid-modifying therapy in Hong Kong.
abstract: BACKGROUND
  Although low-density lipoprotein cholesterol (LDL-C) is the primary lipid target for coronary heart disease (CHD) risk reduction, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) have also emerged as CHD risk factors. The objective of this study was to evaluate attainment of lipid goals and normal levels following lipid-modifying therapy (LMT) and its predictors in a representative sample of Chinese patients from Hong Kong.
  
  
  METHODS
  Using longitudinal data collected from patient medical records, the study identified 706 patients who initiated LMT from January 2004 to December 2006 and had full lipid panels 12 months before and after therapy. LDL-C goals and normal levels of HDL-C and TG were defined according to the National Cholesterol Education Program Adult Treatment Panel 3 guidelines. Patients with previous CHD, diabetes, and 10-year CHD risk > 20% were classified as high risk. Multiple logistic regressions evaluated predictors of normal lipid-level attainment.
  
  
  RESULTS
  Among 706 patients (mean age 64.6 years, 58.6% male), 71.7% had elevated LDL-C, 32.4% had low HDL-C, and 24.9% had elevated TG before LMT. Despite therapy (91.2% statins only), 22.7% had elevated LDL-C, 31.9% had low HDL-C, 12.3% had elevated TG, and 13.9% had multiple abnormal lipid levels. The strongest predictors of attaining ≥ 2 normal lipid levels included male gender (odds ratio [OR]: 2.11 [1.12 to 4.01]), diabetes (OR: 0.43 [0.23 to 0.78]), obesity (OR: 0.91 [0.86 to 0.97]), and CHD risk > 20% (OR: 0.33 [0.15 to 0.71]).
  
  
  CONCLUSIONS
  Current approaches to lipid management in Hong Kong, primarily using statins, considerably improve attainment of LDL-C goal. However, a large proportion of patients do not achieve normal HDL-C levels and control of multiple lipid parameters remains poor. Patients could benefit from a more comprehensive approach to lipid management that treats all three lipid risk factors, as suggested in clinical guidelines.
authors.affiliation: Global Outcomes Research, Merck & Co., Inc., One Merck Drive, P.O. Box 100, WS 2E-65, Whitehouse Station, NJ 08889, USA. baishali_ambegaonkar@merck.com
authors.forename: Baishali
authors.initials: B
authors.lastname: Ambegaonkar
authors.forename: Diana
authors.initials: D
authors.lastname: Chirovsky
authors.forename: Hung Fat
authors.initials: HF
authors.lastname: Tse
authors.forename: Yuk Kong
authors.initials: YK
authors.lastname: Lau
authors.forename: Brian
authors.initials: B
authors.lastname: Tomlinson
authors.forename: Shu Kin
authors.initials: SK
authors.lastname: Li
authors.forename: Chiu Sun
authors.initials: CS
authors.lastname: Yue
authors.forename: Tai Hung
authors.initials: TH
authors.lastname: Wong
authors.forename: Man Chun
authors.initials: MC
authors.lastname: Choi
authors.forename: Prabowo
authors.initials: P
authors.lastname: Tunggal
authors.forename: Vasilisa
authors.initials: V
authors.lastname: Sazonov
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006723:Hong Kong; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D014280:Triglycerides