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Lipid Management in a Japanese Community: Attainment Rate of Target Set by the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012

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ABSTRACT

Aim:: The Japan Atherosclerosis Society (JAS) guidelines for the prevention of atherosclerotic diseases 2012 (JAS2012) proposed lipid management targets; however, less data is available regarding the attainment rates of each target in community-based settings. Therefore, we assessed the attainment rates of lipid management targets among subjects who underwent Japanese specific health checkups.

Methods:: A total of 85,716 subjects (male = 29,282, 34.2%) aged 40–74 years who underwent specific health checkups from 2012 to 2014 in Kanazawa city, Japan, were included in this study. We evaluated the attainment rates of the lipid management targets according to the JAS2012 guideline and investigated the clinical characteristics of the subjects without achieving the targets.

Results:: The target for LDL cholesterol (LDL-C) was the least attained in all risk categories, 89, 72, 50, and 34% for category I, II, III, and secondary prevention, respectively, in 2014. In addition, these rates inversely correlated with the grade of risk categories (p-value for trends <0.001). Attainment rate of the LDL-C target in the suspected chronic kidney disease (CKD) group was significantly lower than in the groups with diabetes, stroke, or absolute risk in category III (49.2, 60.3, 63.5, 54.4%, respectively, p-value <0.001 for each). Moreover, the attainment rate of the LDL-C target was significantly lower in subjects that did not receive lipid-lowering therapy than in those who received it in the secondary prevention (27.7 and 40.6%, respectively, p-value <0.001).

Conclusions:: Lipid management is inadequate in community-based settings, particularly, in subjects with CKD and secondary prevention.

No MeSH data available.


Related in: MedlinePlus

Attainment rates for lipid management targets (2012)Light blue: LDL-C, Orange: HDL-C, Gray: TG, Yellow: Non-HDL-C, Blue: All
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Figure 1: Attainment rates for lipid management targets (2012)Light blue: LDL-C, Orange: HDL-C, Gray: TG, Yellow: Non-HDL-C, Blue: All

Mentions: Attainment rates for lipid management targets are illustrated in Fig. 1–3. In 2012, when the current guideline was introduced, the attainment rate of all four lipid management targets (LDL-C, TG, HDL-C, and non-HDL-C) for all the study subjects was 51.5%. When divided into four categories based on JAS2012, an inverse correlation was observed in the attainment rates of all four lipid management targets according to the category (76.3, 60.7, 35.8, and 24.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). Among the four different targets, LDL-C management target was the least attained (67.3%). Similar to the overall trend, an inverse correlation was observed in the attainment rate of LDL-C management target according to the category (90.4, 75.7, 54.3, and 35.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). In 2013, the overall attainment rate of all the four lipid management targets was 52.0%. An inverse correlation was observed in the attainment rates of all the four lipid management targets according to the category (78.3, 60.0, 33.6, and 25.0%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001) in 2012. Further, an inverse correlation was observed in the attainment rates of LDL-C management target according to the category (89.6, 74.3, 51.6, and 36.1, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). In 2014, we observed the same overall trends (75.9, 57.3, 33.5, and 23.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001), as well as in LDL-C (89.1, 71.5, 50.0, and 34.3%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). We could not observe any significant increases in attainment rates in all of lipid management targets (LDL-C, triglyceride, and HDL-C), from 2012 to 2014.


Lipid Management in a Japanese Community: Attainment Rate of Target Set by the Japan Atherosclerosis Society Guidelines for the Prevention of Atherosclerotic Cardiovascular Diseases 2012
Attainment rates for lipid management targets (2012)Light blue: LDL-C, Orange: HDL-C, Gray: TG, Yellow: Non-HDL-C, Blue: All
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383549&req=5

Figure 1: Attainment rates for lipid management targets (2012)Light blue: LDL-C, Orange: HDL-C, Gray: TG, Yellow: Non-HDL-C, Blue: All
Mentions: Attainment rates for lipid management targets are illustrated in Fig. 1–3. In 2012, when the current guideline was introduced, the attainment rate of all four lipid management targets (LDL-C, TG, HDL-C, and non-HDL-C) for all the study subjects was 51.5%. When divided into four categories based on JAS2012, an inverse correlation was observed in the attainment rates of all four lipid management targets according to the category (76.3, 60.7, 35.8, and 24.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). Among the four different targets, LDL-C management target was the least attained (67.3%). Similar to the overall trend, an inverse correlation was observed in the attainment rate of LDL-C management target according to the category (90.4, 75.7, 54.3, and 35.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). In 2013, the overall attainment rate of all the four lipid management targets was 52.0%. An inverse correlation was observed in the attainment rates of all the four lipid management targets according to the category (78.3, 60.0, 33.6, and 25.0%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001) in 2012. Further, an inverse correlation was observed in the attainment rates of LDL-C management target according to the category (89.6, 74.3, 51.6, and 36.1, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). In 2014, we observed the same overall trends (75.9, 57.3, 33.5, and 23.2%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001), as well as in LDL-C (89.1, 71.5, 50.0, and 34.3%, in category I, II, III, and secondary prevention, respectively, p-value for trend < 0.001). We could not observe any significant increases in attainment rates in all of lipid management targets (LDL-C, triglyceride, and HDL-C), from 2012 to 2014.

View Article: PubMed Central - PubMed

ABSTRACT

Aim:: The Japan Atherosclerosis Society (JAS) guidelines for the prevention of atherosclerotic diseases 2012 (JAS2012) proposed lipid management targets; however, less data is available regarding the attainment rates of each target in community-based settings. Therefore, we assessed the attainment rates of lipid management targets among subjects who underwent Japanese specific health checkups.

Methods:: A total of 85,716 subjects (male = 29,282, 34.2%) aged 40&ndash;74 years who underwent specific health checkups from 2012 to 2014 in Kanazawa city, Japan, were included in this study. We evaluated the attainment rates of the lipid management targets according to the JAS2012 guideline and investigated the clinical characteristics of the subjects without achieving the targets.

Results:: The target for LDL cholesterol (LDL-C) was the least attained in all risk categories, 89, 72, 50, and 34% for category I, II, III, and secondary prevention, respectively, in 2014. In addition, these rates inversely correlated with the grade of risk categories (p-value for trends &lt;0.001). Attainment rate of the LDL-C target in the suspected chronic kidney disease (CKD) group was significantly lower than in the groups with diabetes, stroke, or absolute risk in category III (49.2, 60.3, 63.5, 54.4%, respectively, p-value &lt;0.001 for each). Moreover, the attainment rate of the LDL-C target was significantly lower in subjects that did not receive lipid-lowering therapy than in those who received it in the secondary prevention (27.7 and 40.6%, respectively, p-value &lt;0.001).

Conclusions:: Lipid management is inadequate in community-based settings, particularly, in subjects with CKD and secondary prevention.

No MeSH data available.


Related in: MedlinePlus