title: DemographIc Assessment and EValuation of DEgree of Lipid Control in High Risk Indian DySlipidemia PatiEnts (DIVERSE Study).
abstract: BACKGROUND
  Cardiovascular diseases (CVD's) are the major cause of morbidity and mortality in both developed and developing countries. Many clinical trials have demonstrated that low-density lipoprotein cholesterol (LDL-C) lowering, reduces the incidence of coronary and cerebrovascular events across a broad spectrum of patients at risk. Guidelines for the management of patients at risk have been established in Europe and North America. The guidelines have advocated progressively lower LDL-C targets and more aggressive use of statin therapy. In Indian patients, comprehensive data on dyslipidemia management and its treatment outcomes are inadequate. There is lack of information on existing treatment patterns, the patient's profile being treated, and factors that determine treatment success or failure in achieving desired goals.
  
  
  OBJECTIVE
  The present study was planned to determine the lipid control status in high-risk dyslipidemic patients treated with lipid-lowering therapy in India.
  
  
  METHODS
  This cross-sectional, non-interventional, single visit program was conducted across 483 sites in India where male and female patients with high-risk dyslipidemia aged 18 to 65 years who had visited for a routine health check-up to their respective physician at hospital or a healthcare center. Percentage of high-risk dyslipidemic patients achieving adequate LDL-C level (< 70 mg/dL) on lipid-lowering therapy and the association of lipid parameters with patient characteristics, comorbid conditions, and lipid lowering drugs were analysed.
  
  
  RESULTS
  3089 patients were enrolled in the study; of which 64% were males. LDL-C data was available for 95.2% of the patients; only 7.7% of these patients achieved LDL-C levels < 70 mg/dL on lipid-lowering therapy, which may be due to inability to follow therapeutic plans, poor compliance, or inadequate counselling by physician. The physician's lack of awareness about recent treatment guidelines also might contribute to patients' poor adherence, not explaining adequately the benefit and risks of a medication, not giving consideration to the patient's life style and the cost of medication. Statin was the most commonly used anti-dyslipidemic drug across population. The higher proportion of patients had the comorbid condition of CVD and diabetes mellitus across all dyslipidemic patients.
  
  
  CONCLUSIONS
  As per the European Society of Cardiology guidelines the ideal LDL-C levels in high risk dyslipidemic patients should be less than 70 mg/dL. In the present study, 7.7% of the patients achieved LDL-C levels < 70 mg/dL on lipid lowering therapy which is very less. Most of high risk dyslipidemic patients in India are on suboptimal dosage of statin. So more aggressive and high dosage statin therapy may be required to achieve target LDLC levels in high risk Indian dyslipidemic patients.
authors.affiliation: Aditya Hospital, Ahmedabad, Gujarat.
authors.forename: Naresh
authors.initials: N
authors.lastname: Malhotra
authors.affiliation: MK Keshan Clinic, Guwahati, Assam.
authors.forename: M K
authors.initials: MK
authors.lastname: Keshan
authors.affiliation: Agarwal Poly Clinic, Jaipur, Rajasthan.
authors.forename: Avinash
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Vismaya Diabetes Care Centre, Bangalore, Karnataka.
authors.forename: R Anil
authors.initials: RA
authors.lastname: Kumar
authors.affiliation: Chief Manager Cardiology.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Trailokya
authors.affiliation: Medical Adviser.
authors.forename: Kalpesh
authors.initials: K
authors.lastname: Dalvi
authors.affiliation: Manager-Clinical Research, Abbott Healthcare Private Limited, Mumbai, Maharashtra.
authors.forename: Suhas
authors.initials: S
authors.lastname: Talele
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003710:Demography; D050171:Dyslipidemias / Q000188:drug therapy*; D005060:Europe; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007194:India; D008055:Lipids; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids