title: Factors influencing low-density lipoprotein cholesterol target achievement in primary care - Results from DYSIS China.
abstract: BACKGROUND
  Primary care facilities are the base for hypercholesterolemia treatment. However, data regarding the effectiveness of lipid management in primary care are lacking.
  
  
  RESULTS
  To evaluate lipid management in the primary care setting in China, we compared patients' characteristics and lipid management outcomes between 6100 outpatients treated at primary care versus 19,217 patients in non-primary settings using data from the DYSlipidemia International Study-China (DYSIS-CHINA). Compared to patients treated at non-primary hospitals, patients who received treatment at primary settings were younger, thinner, and were more likely to be female and to have a family history of premature CVD. Overall, 26.8% of very high-risk and 40.8% of high-risk patients achieved the LDL-C target with primary care treatment, whereas these target rates were 41.2% (p<0.001) and 58.6% (p<0.001), respectively, among patients treated at non-primary hospitals. High-dose statin therapy was underused in primary care patients compared to non-primary hospital patients (p<0.001). Logistic regression analysis showed that female gender, diabetes, and obesity were negative factors, whereas life-style modification and use of high-dose statin (40mg/d simvastatin equivalent) were favorable factors in predicting LDL-C target attainment in the primary care setting.
  
  
  CONCLUSIONS
  Sedentary life style, alcohol drinking, and use of suboptimal statin dosage are key factors that unfavorably affect the LDL-C target rate among patients treated at primary care facilities in China. Sufficient training for primary care physicians regarding proper statin use and support for the combined use of a statin with ezetimibe could promote LDL-C target attainment in primary care.
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: RuiYi
authors.initials: R
authors.lastname: Xu
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Ligang
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Peking University People's Hospital, No.11, Xi Zhi Men Nan Da Jie, Xicheng District, Beijing 100044, China.
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Cardiology, Second Xiangya Hospital, Central South University, No.139, People Street (M.), Changsha 410011, China.
authors.forename: Shuiping
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xi Li, Dongcheng District, Beijing 100050, China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: MSD China Holding Co., Ltd., No. 1601, Nanjing Rd.(W), JingAn District, Shanghai 20004, China.
authors.forename: Jihu
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: yanxw@pumch.cn.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Yan
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000145:classification / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D002681:China / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration / Q000706:statistics & numerical data; D008875:Middle Aged; D020380:Needs Assessment; D011320:Primary Health Care / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL
keywords: Dyslipidemia; LDL-C attainment; Primary care