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Achieving vascular risk factor targets: a survey of a London general practice.
Angiology. 2008 Feb-Mar; 59(1):36-46.A

Abstract

We assessed lipid goal achievement in patients at high risk for vascular events from a general practice (London, United Kingdom). Patients were identified as those with a prescription for hypolipidaemic medication, a significant (>20%) Framingham risk, and from the myocardial infarction register. Two hundred forty-five patients were currently taking a statin (average dose, 23.1 mg/day). Cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides changed significantly following statin treatment. Of 285 patients who had taken statins at some time point, 11 (3.9%) were intolerant, 5 of which subsequently tolerated another statin. Approximately 10.1% of patients discontinued statin treatment for unclear reasons. Only 64 patients (29.1% of 220) reached the Joint British Societies' Guidelines on Prevention of Cardiovascular Disease target of a total cholesterol of <4.0 mmol/L; 50 patients (38.8% of 129) reached the low-density lipoprotein-cholesterol target of <2.0 mmol/L. This value of low-density lipoprotein-cholesterol is similar to that recommended by the American Heart Association/American College of Cardiology. With regard to the General Medical Services guidelines target for total cholesterol, 162 (73.6% of 220) patients reached <or=5.0 mmol/L. The group that best achieved target cholesterol (Joint British Societies' Guidelines and General Medical Services) were those with comorbidities. In conclusion, while reaching General Medical Services targets was satisfactory, the percentage of patients reaching Joint British Societies' Guidelines targets was not. This discrepancy may reflect the presence of multiple guidelines. The current stricter lipid targets are difficult to achieve; possible methods that may be used to improve lipids further could involve using combination therapy, statin dose titration, and better education.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Levine AP
The Crouch Hall Road Surgery, Hornsey, United Kingdom.
Mikhailidis DP
No affiliation info available
Moross T
No affiliation info available
Benson K
No affiliation info available
Gor M
No affiliation info available

MeSH

AdultAgedAged, 80 and overCardiovascular DiseasesCholesterolCholesterol, HDLCholesterol, LDLComorbidityCreatine KinaseDrug Therapy, CombinationFamily PracticeFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHyperlipidemiasLipidsLiver Function TestsLondonMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesRisk AssessmentRisk FactorsTreatment OutcomeTriglycerides

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18319220

Citation

Levine, Adam P., et al. "Achieving Vascular Risk Factor Targets: a Survey of a London General Practice." Angiology, vol. 59, no. 1, 2008, pp. 36-46.
Levine AP, Mikhailidis DP, Moross T, et al. Achieving vascular risk factor targets: a survey of a London general practice. Angiology. 2008;59(1):36-46.
Levine, A. P., Mikhailidis, D. P., Moross, T., Benson, K., & Gor, M. (2008). Achieving vascular risk factor targets: a survey of a London general practice. Angiology, 59(1), 36-46. https://doi.org/10.1177/0003319707309538
Levine AP, et al. Achieving Vascular Risk Factor Targets: a Survey of a London General Practice. Angiology. 2008 Feb-Mar;59(1):36-46. PubMed PMID: 18319220.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achieving vascular risk factor targets: a survey of a London general practice. AU - Levine,Adam P, AU - Mikhailidis,Dimitri P, AU - Moross,Tessa, AU - Benson,Karen, AU - Gor,Mayur, PY - 2008/3/6/pubmed PY - 2008/4/5/medline PY - 2008/3/6/entrez SP - 36 EP - 46 JF - Angiology JO - Angiology VL - 59 IS - 1 N2 - We assessed lipid goal achievement in patients at high risk for vascular events from a general practice (London, United Kingdom). Patients were identified as those with a prescription for hypolipidaemic medication, a significant (>20%) Framingham risk, and from the myocardial infarction register. Two hundred forty-five patients were currently taking a statin (average dose, 23.1 mg/day). Cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides changed significantly following statin treatment. Of 285 patients who had taken statins at some time point, 11 (3.9%) were intolerant, 5 of which subsequently tolerated another statin. Approximately 10.1% of patients discontinued statin treatment for unclear reasons. Only 64 patients (29.1% of 220) reached the Joint British Societies' Guidelines on Prevention of Cardiovascular Disease target of a total cholesterol of <4.0 mmol/L; 50 patients (38.8% of 129) reached the low-density lipoprotein-cholesterol target of <2.0 mmol/L. This value of low-density lipoprotein-cholesterol is similar to that recommended by the American Heart Association/American College of Cardiology. With regard to the General Medical Services guidelines target for total cholesterol, 162 (73.6% of 220) patients reached <or=5.0 mmol/L. The group that best achieved target cholesterol (Joint British Societies' Guidelines and General Medical Services) were those with comorbidities. In conclusion, while reaching General Medical Services targets was satisfactory, the percentage of patients reaching Joint British Societies' Guidelines targets was not. This discrepancy may reflect the presence of multiple guidelines. The current stricter lipid targets are difficult to achieve; possible methods that may be used to improve lipids further could involve using combination therapy, statin dose titration, and better education. SN - 0003-3197 UR - https://www.unboundmedicine.com/medline/citation/18319220/Achieving_vascular_risk_factor_targets:_a_survey_of_a_London_general_practice_ DB - PRIME DP - Unbound Medicine ER -