The evaluation of low-density lipoprotein cholesterol goals achieved in patients with established cardiovascular disease and/or hyperlipidaemia receiving lipid lowering therapy

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2009-05-19T09:49:56Z

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Ramjeeth, Akash

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Abstract

Background:Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. A major risk factor for CVD is hypercholesterolaemia. As a result the South African scientific community has updated its clinical guidelines for CVD management by adoption of the current European cardiovascular disease guidelines. The South African Not at Goal Study (SA-NAG) was a survey to determine the percentage of patients, on lipid-lowering therapy, who are not achieving guideline specified low density lipoprotein cholesterol (LDL-C) goals. Design: A cross-sectional study. Methods: In this study, dyslipidaemic and/or CVD patients on lipid lowering therapy for > 4 months were enrolled. Volunteers had their demographic data and previous medical history documented. Fasting lipid and blood glucose levels were measured in all subjects. Results: In total 1201 patients (age 58±11.4 yrs) were recruited by physicians and general practitioners. Under the new guidelines, 41% of patients are defined as Low Risk (LR) and 59% of patients are High Risk (HR) for CVD. LDL-C target goals were not achieved in 63% of LR patients and 77% of HR patients (71% overall). LR and HR patients, who were not at their LDL-C goal, were on average 19% (0.7 mmol/L) and 31% (1.1 mmol/L) above their LDL-C target levels respectively. Conclusions These results, in light of the new guidelines, suggest that a considerable percentage of patients will fall into the category of “not at goal” LDL-C. The adoption of the new guidelines will necessitate enhanced disease management to reduce the extent of hypercholesterolaemia and risk for CVD.

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cholesterol, heart disease, South Africa

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