title: The effect of the intensity of lipid-lowering medications on the LDL cholesterol treatment goals of Asian patients with dyslipidaemia in primary care.
abstract: OBJECTIVE
  Dyslipidaemia is the key risk factor for arthrosclerosis, leading to myocardial infarctions and strokes. Achieving LDL cholesterol (LDL-C) treatment goals using lipid-lowering therapy (LLT) mitigates such cardiovascular risks. This study aimed to determine the proportions and factors influencing patients with dyslipidaemia on LLT who achieved their recommended LDL-C treatment goals.
  
  
  METHODS
  Adult Asian patients with dyslipidaemia, aged 31-80 years, were enrolled in a questionnaire survey. Using simplified Framingham risk scores, these patients were classified into low (LR), medium (MR) and high (HR) cardiovascular risk groups. Their lipid-lowering therapy was classified into low-intensity (LI), medium-intensity (MI) and high-intensity (HI) groups according to the 2013 American College of Cardiology and American Heart Association (ACC/AHA) Blood Cholesterol Guidelines. Data on their demographic, clinical, self-reported attitude and adherence to LLT were correlated with their latest lipid profiles from their electronic health records. These data were analysed using chi-square test, or independent t-test where appropriate for categorical variables and continuous data. Logistic regression was used to identify factors relating to LDL-C goal attainment.
  
  
  CONCLUSIONS
  Amongst the 917 patients treated with LLT, 60·9% were females and 56·2% aged >60 years. The commonest statins prescribed were simvastatin (77·7%), atorvastatin (15·3%), rosuvastatin (4·3%) and lovastatin (3·4%). Those who attained LDL-C treatment goals included 89·4%, 77·4% and 70% of the LR, MR and HR groups. Overall, 72·4% of the patients achieved LDL-C treatment goals. Despite 98·4% of them self-reported LLT adherence, only 85·5%, 69·5% and 50% of the LI, MI and HI subgroups attained the desired outcomes, respectively.
  
  
  CONCLUSIONS
  Overall, 27·6% of patients with dyslipidaemia, including 30% of the HR group, did not achieve LDL-C treatment goals, despite on LLT. Addressing their concerns and adjusting medication doses of their LLT are needed for better outcomes.
authors.affiliation: SingHealth Polyclinics, Singapore, Singapore. tan.ngiap.chuan@singhealth.com.sg.|Duke NUS Medical School, Singapore, Singapore. tan.ngiap.chuan@singhealth.com.sg.
authors.forename: N C
authors.initials: NC
authors.lastname: Tan
authors.affiliation: SingHealth Polyclinics, Singapore, Singapore.
authors.forename: C C
authors.initials: CC
authors.lastname: Goh
authors.affiliation: SingHealth Polyclinics, Singapore, Singapore.|Duke NUS Medical School, Singapore, Singapore.|Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: S C P
authors.initials: SC
authors.lastname: Goh
authors.affiliation: SingHealth Polyclinics, Singapore, Singapore.
authors.forename: Y L E
authors.initials: YL
authors.lastname: Koh
authors.affiliation: SingHealth Polyclinics, Singapore, Singapore.
authors.forename: K H
authors.initials: KH
authors.lastname: Koh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D044466:Asian People; D000069059:Atorvastatin / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000379:methods; D012307:Risk Factors; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use; D019821:Simvastatin / Q000627:therapeutic use
chemical_list: D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin; D019821:Simvastatin
keywords: LDL cholesterol; dyslipidaemia; intensity; medication adherence; risk; statin