title: Achieving low-density lipoprotein cholesterol treatment goals among dyslipidemic individuals in the Levant: the CEntralized Pan-Levant survey on tHE Undertreatment of hypercholeSterolemia (CEPHEUS) study.
abstract: BACKGROUND
  Several studies that evaluated achieving lipid goals have demonstrated an undertreatment of dyslipidemia. We evaluated the use and efficacy of lipid-lowering agents (LLAs) in reducing low-density lipoprotein cholesterol (LDL-C) to recommended levels in the Levant region.
  
  
  METHODS
  A multi-center, cross-sectional survey enrolled 1002 dyslipidemic patients (August 2010 - January 2011) on LLAs for ≥3 months. Collection of data and blood samples was done over one visit. Physicians and patients filled out questionnaires pertaining to dyslipidemia diagnosis and treatment. LDL-C target levels were defined according to international guidelines.
  
  
  RESULTS
  The full analysis set included 992 patients. Mean age was 58.0 ± 11.6 years (41% women, 65.7% diabetics and 51.5% had history of coronary heart disease). LLAs were prescribed for primary prevention or secondary prevention or familial hypercholesterolemia in 45.8% and 52.8% and 1.4% of patients; respectively. Overall, 64.0% and 56.8% of the patients attained their LDL-C goal recommended by the NCEP ATP III and TJETF guidelines, respectively. According to the 2004 NCEP ATP III updated guidelines, about 24.8% of the very high risk group attained their LDL goal of ≤70 mg/dL. Smoking, diabetes, metabolic syndrome, history of cardiovascular disease, increased waist circumference, and elevated pre-treatment LDL-C level were all associated with not reaching LDL-C goals.
  
  
  CONCLUSIONS
  Although the study cohort was a relatively high risk group and might not be representative of the general population, we found that about 60% of enrolled individuals achieved the LDL-C treatment goals and 24.8% of the very high risk group achieved the recommended LDL-C targets of ≤70 mg/dl; national strategies and aggressive awareness campaigns to effectively control lipid levels to recommended target levels, especially in the high risk groups, are urgently needed.
authors.affiliation: Cardiology Department, Istishari Hospital , Amman , Jordan.
authors.forename: Ayman J
authors.initials: AJ
authors.lastname: Hammoudeh
authors.forename: Akram
authors.initials: A
authors.lastname: Echtay
authors.forename: Georges Y
authors.initials: GY
authors.lastname: Ghanem
authors.forename: Jihad
authors.initials: J
authors.lastname: Haddad
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D015994:Incidence; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017211:Treatment Failure
chemical_list: D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents
keywords: Cardiovascular diseases; Low-density lipoprotein cholesterol; Statins; Treatment goals