title: Asian patients with dyslipidemia in an urban population: Effect of ethnicity on their LDL-cholesterol treatment goals.
abstract: BACKGROUND
  Dyslipidemia is the primary risk factor for arthrosclerosis. It is the most common chronic disease among the multiethnic Asian population in Singapore. Local national health survey has shown ethnic variability in achieving control of dyslipidemia.
  
  
  OBJECTIVE
  This study aimed to determine the proportion of patients in primary care, who achieved their low-density lipoprotein (LDL)-cholesterol treatment goals, stratified by the local major ethnic groups. It also evaluated the factors that affected their dyslipidemia control, including diet, exercise and medication usage.
  
  
  METHODS
  Research assistants administered questionnaires on adult patients with physician-diagnosed dyslipidemia to determine their views on diet, exercise, and medications in this cross-sectional study in 2 local primary care clinics. Their lipid profiles were retrieved from their laboratory reports in their electronic health records. Chi-square and Fisher exact tests were used for the categorical demographics and questionnaire variables, (P < .05: statistically significant). Logistic regression was performed using these significant variables to determine the adjusted odds of the ethnic groups.
  
  
  RESULTS
  A total of 1093 eligible patients completed the questionnaires. The proportion of Chinese, Malay, and Indian patients who achieved LDL-cholesterol goals was 78.3%, 67.9%, and 68.5%, respectively. Among those who self-reported taking their favorite cholesterol-rich food occasionally when their cholesterol became controlled, 35.8% Indians failed to achieve treatment goals, compared to 20.1% Chinese and 30.9% Malay patients. Regular medication adherence was associated with 81.8% Chinese, 69.0% Malay, and 69.7% Indian reaching treatment goals.
  
  
  CONCLUSIONS
  More Chinese met LDL-cholesterol treatment goals compared to Malays and Indians. Lipid-lowering medications enabled but smoking hindered their achievement of these treatment goals.
authors.affiliation: SingHealth Polyclinics, Singapore; Duke NUS Medical School, Singapore. Electronic address: tan.ngiap.chuan@singhealth.com.sg.
authors.forename: Ngiap Chuan
authors.initials: NC
authors.lastname: Tan
authors.affiliation: SingHealth Polyclinics, Singapore.
authors.forename: Kim Hwee
authors.initials: KH
authors.lastname: Koh
authors.affiliation: SingHealth Polyclinics, Singapore.
authors.forename: Chin Chin
authors.initials: CC
authors.lastname: Goh
authors.affiliation: SingHealth Polyclinics, Singapore; NUS Yong Loo Lin School of Medicine, Singapore.
authors.forename: Yi Ling Eileen
authors.initials: YL
authors.lastname: Koh
authors.affiliation: SingHealth Polyclinics, Singapore; Duke NUS Medical School, Singapore.
authors.forename: Soo Chye Paul
authors.initials: SC
authors.lastname: Goh
mesh_terms: D000328:Adult; D044466:Asian People / Q000208:ethnology*; D008078:Cholesterol, LDL / Q000378:metabolism*; D003430:Cross-Sectional Studies; D004032:Diet; D050171:Dyslipidemias / Q000188:drug therapy* / Q000208:ethnology*; D015444:Exercise; D005260:Female; D006040:Goals; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data; D014505:Urban Population
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Dyslipidemia; Ethnicity; LDL-Cholesterol; Lipid control; Treatment goal