Limits...
Changes in attainment of lipid goals by general practitioners and specialists in patients at high cardiovascular risk in Hungary during 2004-2008.

Mark L, Paragh G, Karadi I, Reiber I, Pados G - Arch Med Sci (2010)

Bottom Line: During this 4-year period the LDL-C level decreased by 0.73 mmol/l and the LDL-C goal achievement rate increased from 14 to 32% in patients treated by GPs.LDL-C showed a decrease of 0.48 mmol/l and the goal achievement rate changed from 20 to 43% in patients treated by specialists.More attention needs to be paid to changing treatment of patients to achieve target levels.

View Article: PubMed Central - PubMed

Affiliation: 2 Department of Internal Medicine - Cardiology, Pandy Kalman Bekes County Hospital, Gyula, Hungary.

ABSTRACT

Introduction: Lipid-lowering therapy should achieve target levels. We assessed the change of the achievement of targets and the mean low-density lipoprotein cholesterol (LDL-C) levels in high-risk Hungarian patients.

Material and methods: Six studies performed with patients of general practitioners (GPs) and specialists between 2004 and 2008 were evaluated: 9,508 patients from GPs and 2809 from specialist practices (total 12,317).

Results: During this 4-year period the LDL-C level decreased by 0.73 mmol/l and the LDL-C goal achievement rate increased from 14 to 32% in patients treated by GPs. LDL-C showed a decrease of 0.48 mmol/l and the goal achievement rate changed from 20 to 43% in patients treated by specialists. In the majority of the patients not achieving the LDL-C goal (57% for specialists and 89% for GPs) there was no modification in the current therapy. In addition to emphasizing the priority of LDL-C lowering, we should also strive for residual risk reduction, which means raising high-density lipoprotein cholesterol (HDL-C) and lowering triglyceride levels. There was no significant improvement in HDL-C or triglyceride levels during the examined period.

Conclusion: More attention needs to be paid to changing treatment of patients to achieve target levels.

No MeSH data available.


Related in: MedlinePlus

Distribution of LDL cholesterol levels of patients at high risk treated by GPs over the years
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Figure 2: Distribution of LDL cholesterol levels of patients at high risk treated by GPs over the years

Mentions: The change of treatment efficacy is specially marked if LDL-C distribution of treated patients is studied (Figure 2). Data of CEL Program 2004 show a Gaussian curve and despite the treatment the proportion of patients below 2.5 mmol/l is apparently very low. 2008 brought a left shift of the distribution curve. Area under the curve of the target value is about double that of 2004. The proportion of patients with LDL-C over 3 mmol/l – 3.0 mmol/l would be the target value in high-risk patients without symptoms [9] – at GPs remained high; it was 72% in 2004, and despite the considerable improvement, 51% in 2008. 1.8 mmol/l (the target value for patients at very high risk, which has major implications for the progression of atherosclerosis), was achieved in 2004 in only 5% of the patients, whereas in 2008 it was achieved in 20%.


Changes in attainment of lipid goals by general practitioners and specialists in patients at high cardiovascular risk in Hungary during 2004-2008.

Mark L, Paragh G, Karadi I, Reiber I, Pados G - Arch Med Sci (2010)

Distribution of LDL cholesterol levels of patients at high risk treated by GPs over the years
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3298337&req=5

Figure 2: Distribution of LDL cholesterol levels of patients at high risk treated by GPs over the years
Mentions: The change of treatment efficacy is specially marked if LDL-C distribution of treated patients is studied (Figure 2). Data of CEL Program 2004 show a Gaussian curve and despite the treatment the proportion of patients below 2.5 mmol/l is apparently very low. 2008 brought a left shift of the distribution curve. Area under the curve of the target value is about double that of 2004. The proportion of patients with LDL-C over 3 mmol/l – 3.0 mmol/l would be the target value in high-risk patients without symptoms [9] – at GPs remained high; it was 72% in 2004, and despite the considerable improvement, 51% in 2008. 1.8 mmol/l (the target value for patients at very high risk, which has major implications for the progression of atherosclerosis), was achieved in 2004 in only 5% of the patients, whereas in 2008 it was achieved in 20%.

Bottom Line: During this 4-year period the LDL-C level decreased by 0.73 mmol/l and the LDL-C goal achievement rate increased from 14 to 32% in patients treated by GPs.LDL-C showed a decrease of 0.48 mmol/l and the goal achievement rate changed from 20 to 43% in patients treated by specialists.More attention needs to be paid to changing treatment of patients to achieve target levels.

View Article: PubMed Central - PubMed

Affiliation: 2 Department of Internal Medicine - Cardiology, Pandy Kalman Bekes County Hospital, Gyula, Hungary.

ABSTRACT

Introduction: Lipid-lowering therapy should achieve target levels. We assessed the change of the achievement of targets and the mean low-density lipoprotein cholesterol (LDL-C) levels in high-risk Hungarian patients.

Material and methods: Six studies performed with patients of general practitioners (GPs) and specialists between 2004 and 2008 were evaluated: 9,508 patients from GPs and 2809 from specialist practices (total 12,317).

Results: During this 4-year period the LDL-C level decreased by 0.73 mmol/l and the LDL-C goal achievement rate increased from 14 to 32% in patients treated by GPs. LDL-C showed a decrease of 0.48 mmol/l and the goal achievement rate changed from 20 to 43% in patients treated by specialists. In the majority of the patients not achieving the LDL-C goal (57% for specialists and 89% for GPs) there was no modification in the current therapy. In addition to emphasizing the priority of LDL-C lowering, we should also strive for residual risk reduction, which means raising high-density lipoprotein cholesterol (HDL-C) and lowering triglyceride levels. There was no significant improvement in HDL-C or triglyceride levels during the examined period.

Conclusion: More attention needs to be paid to changing treatment of patients to achieve target levels.

No MeSH data available.


Related in: MedlinePlus