title: Attainment of multifactorial treatment targets among the elderly in a lipid clinic.
abstract: OBJECTIVE
  To examine target attainment of lipid-lowering, antihypertensive and antidiabetic treatment in the elderly in a specialist setting of a University Hospital in Greece.
  
  
  METHODS
  This was a retrospective study including consecutive subjects ≥ 65 years old (n = 465) with a follow-up ≥ 3 years. Low-density lipoprotein cholesterol (LDL-C), blood pressure (BP) and glycated hemoglobin (HbA1c) goal achievement were recorded according to European Society of Cardiology/European Atherosclerosis Society (ESC/EAS), European Society of Hypertension (ESH)/ESC and European Association for the Study of Diabetes (EASD) guidelines.
  
  
  RESULTS
  The LDL-C targets were attained by 27%, 48% and 62% of very high, high and moderate risk patients, respectively. Those receiving statin + ezetimibe achieved higher rates of LDL-C goal achievement compared with those receiving statin monotherapy (48% vs. 33%, P < 0.05). Of the diabetic subjects, 71% had BP < 140/85 mmHg, while 78% of those without diabetes had BP < 140/90 mmHg. A higher proportion of the non-diabetic individuals (86%) had BP < 150/90 mmHg. Also, a higher proportion of those with diabetes had HbA1c < 8% rather than < 7% (88% and 47%, respectively). Of note, almost one out of three non-diabetic individuals and one out of ten diabetic individuals had achieved all three treatment targets.
  
  
  CONCLUSIONS
  Even in a specialist setting of a University Hospital, a high proportion of the elderly remain at suboptimal LDL-C, BP and HbA1c levels. The use of drug combinations could improve multifactorial treatment target attainment, while less strict targets could be more easily achieved in this population.
authors.affiliation: Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Fotios
authors.initials: F
authors.lastname: Barkas
authors.affiliation: Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liberopoulos
authors.affiliation: Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Klouras
authors.affiliation: Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Angelos
authors.initials: A
authors.lastname: Liontos
authors.affiliation: Department of Internal Medicine, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Moses
authors.initials: M
authors.lastname: Elisaf
keywords: Blood pressure; Glycated hemoglobin; Goal achievement; Low-density lipoprotein cholesterol