title: A contemporary cross-sectional study on dyslipidemia management, cardiovascular risk status, and patients' quality of life in Greece: The CHALLENGE study.
abstract: BACKGROUND
  Prior studies conducted in Greece consistently indicate that dyslipidemia is suboptimally managed, while the burden of cardiovascular disease (CVD) and related risk factors is rising.
  
  
  METHODS
  CHALLENGE was a multicenter, cross-sectional study carried out following the publication of guidelines advocating stricter low-density lipoprotein cholesterol (LDL-C) targets. It primarily aimed to depict LDL-C target attainment, and to assess the cardiovascular risk status and quality of life (QoL) of patients treated in a primary or secondary CVD prevention setting who had received any medical intervention for cardiovascular risk modification within 6months of enrollment.
  
  
  RESULTS
  Between December 2012 and April 2013, 500 patients (55% males) aged (mean±SD) 62.0±11.7years, participated in the study. Cardiovascular risk according to the 2011 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines was 'very high', 'high', and 'moderate' in 61.2%, 23.4%, and 15.4%, respectively. Overall, 92.0% of patients were on lipid-lowering treatment, yet only 23.3% had attained their ESC/EAS-defined LDL-C target. LDL-C target attainment was more likely among 'moderate' versus 'very high' cardiovascular risk patients (odds ratio: 4.04; 95% confidence interval: 2.32-7.06; p<0.001). QoL improved as cardiovascular risk decreased (EQ-VAS 71.8±16.2 in the 'very high' versus 78.3±15.1 and 80.3±15.7 in the 'high' and 'moderate' risk groups; p<0.001). Time constraints and difficulties in implementation in daily practice were the investigator's main barriers for guideline utilization.
  
  
  CONCLUSIONS
  During contemporary management of dyslipidemia in Greece, LDL-C target attainment is suboptimal. There is an undoubted need for improvement and implementation of cardiovascular risk assessment in routine clinical practice.
authors.affiliation: Department of Cardiology, Patras University Hospital, Patras, Greece. Electronic address: dalex@med.upatras.gr.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Alexopoulos
authors.affiliation: Department of Cardiology, "Attikon" University Hospital of Athens, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Anastasiou-Nana
authors.affiliation: Department of Internal Medicine, , University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Moses S
authors.initials: MS
authors.lastname: Elisaf
authors.affiliation: Department of Internal Medicine, , University Hospital of Ioannina, Ioannina, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Liberopoulos
authors.affiliation: Department of Cardiology, "Attikon" University Hospital of Athens, Athens, Greece.
authors.forename: Loukianos S
authors.initials: LS
authors.lastname: Rallidis
authors.affiliation: Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece.
authors.forename: Constantinos H
authors.initials: CH
authors.lastname: Davos
authors.affiliation: Medical Department, AstraZeneca SA, Athens, Greece.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Moulis
authors.affiliation: Medical Department, AstraZeneca SA, Athens, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Nikas
authors.affiliation: Department of Cardiology, Heraklion University Hospital, Crete, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Zacharis
authors.affiliation: Department of Cardiology, Heraklion University Hospital, Crete, Greece.
authors.forename: Panos
authors.initials: P
authors.lastname: Vardas
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000378:metabolism*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents
keywords: CV risk; Dyslipidemia guideline adherence; ESC/EAS guidelines; LDL-C target; Quality of life