title: Contemporary management and attainment of cholesterol targets for patients with dyslipidemia in China.
abstract: OBJECTIVE
  It is well-established that lipid disorder is an important cardiovascular risk factor, and failure to reach optimal lipid levels significantly contributes to the residual cardiovascular risks. However, limited information is available on the management and the attainment of recommended cholesterol targets in real-world practice in China.
  
  
  RESULTS
  A nationally representative sample of 12,040 patients with dyslipidemia from 19 provinces and 84 hospitals across China were consecutively enrolled in this survey. Risk stratification and individual cholesterol target was established for all participants. This survey identified a high-risk cohort, with over 50% of patients had hypertension, 37.5% had coronary artery disease, and more than 30% had peripheral artery disease. Thirty-nine percent of all participants received lipid lowering medications. And the majority of them (94.5%) had statins (42.5% with atorvastatin, 29.0% with simvastatin, and 15.2% with rosuvastatin). However, the overall attainment for low-density lipoprotein cholesterol (LDL-C) target is low (25.8%), especially, in female (22.2%), and in patients with increased body mass index (BMI) (38.3% for BMI<18.5, 28.1% for BMI 18.5-24.9, 26.0% for BMI 25.0-29.9, and 17.4% for BMI ≥ 30, P<0.0001). Subgroup analysis also showed the attainment is significantly lower in patients who were stratified into high (19.9%) and very high (21.1%) risk category. In logistic regression analysis, eight factors (BMI, gender, coronary artery disease, systolic and diastolic blood pressure, hypertension, family history of premature coronary artery disease and current smoking) were identified as independent predictors of LDL-C attainment.
  
  
  CONCLUSIONS
  Despite the proven benefits of lipid-lowering therapies, current management of dyslipidemia continues to be unsatisfied. A considerable proportion of patients failed to achieve guideline-recommended targets in China, and this apparent treatment gap was more pronounced among patients with increased BMI, higher risk stratification and women.
authors.affiliation: Department of Cardiology, An Zhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Da Yi
authors.initials: DY
authors.lastname: Hu
authors.forename: Ying Xin
authors.initials: YX
authors.lastname: Zhao
authors.forename: Yu Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Zhi Jian
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Shi Wei
authors.initials: SW
authors.lastname: Yang
authors.forename: Xiao Li
authors.initials: XL
authors.lastname: Liu
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance; D012307:Risk Factors
chemical_list: D000960:Hypolipidemic Agents; D002784:Cholesterol