title: Adherence to guidelines to prevent cardiovascular diseases: The LifeLines cohort study.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of death worldwide. While there is indisputable evidence that statin treatment reduces the burden of CVD, undertreatment remains a concern for primary and secondary prevention. The aim of this study was to assess the use of lipid-lowering drugs (LLD) among 70,292 individuals in the Netherlands as a proxy of adherence to the national guideline for prevention and treatment of CVD.
  
  
  METHODS
  LifeLines is a population-based prospective cohort study in the three Northern provinces of the Netherlands. At baseline, all participants completed questionnaires, and underwent a physical examination and lab testing. The national guidelines were used to assess how many participants were eligible for LLD prescription and we analysed how many indeed reported LLD use.
  
  
  RESULTS
  For primary prevention, 77% (2515 of 3268) of those eligible for LLD treatment did not report using these drugs, while for secondary prevention this was 31% (403 of 1302). Patients with diabetes mellitus were treated best (67%) for primary prevention. Notably, of the patients with stroke, only 47% (182 of 386) reported LLD treatment.
  
  
  CONCLUSIONS
  Despite clear guidelines and multiple national initiatives to improve CVD risk management, adherence to guidelines for the treatment of CVD in the Netherlands remains a major challenge. This study calls out for improving public awareness of CVD and to improve primary and secondary prevention to prevent unnecessary CVD-related morbidity and mortality.
authors: Department of Pediatrics, Section Molecular Genetics, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
authors: J W
authors: JW
authors: Balder
authors: S
authors: S
authors: Scholtens
authors: J K
authors: JK
authors: de Vries
authors: L M
authors: LM
authors: van Schie
authors: S M
authors: SM
authors: Boekholdt
authors: G K
authors: GK
authors: Hovingh
authors: P W
authors: PW
authors: Kamphuisen
authors: J A
authors: JA
authors: Kuivenhoven
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000188:drug therapy; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000706:statistics & numerical data; D011446:Prospective Studies; D055502:Secondary Prevention / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors