Unmet need in the hyperlipidaemia population with high risk of cardiovascular disease: a targeted literature review of observational studies

BMC Cardiovascular Disorders

Research Article

M. Samuel¹  S. Roso²  S. Mitchell³  M. Pladevall-Vila⁴ 

[1] NUS Yong Loo Lin School of Medicine, NUHS Tower Block, Level 11, 1E Kent Ridge Road, 119228, Singapore, Singapore;Pfizer Ltd., Walton Oaks, Dorking Road, Walton-on-the-Hill, KT20 7NS, Tadworth, Surrey, UK;RTI Health Solutions, The Pavilion, Towers Business Park, Wilmslow Road, M20 2LS, Manchester, Didsbury, UK;RTI Health Solutions, Trav. Gracia 56 Atico 1 08006, Barcelona, Spain;The Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA;

关键词: Hyperlipidaemia;    LDL-C;    Cardiovascular;    Mortality;    Review;    Observational studies;   

DOI  :  10.1186/s12872-016-0241-3

 received in 2015-10-13, accepted in 2016-04-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to examine recommended target levels of low-density lipoprotein cholesterol (LDL-C) for hyperlipidaemia patients at high risk (i.e., with two or more risk factors or coronary heart disease or its risk equivalents) for cardiovascular disease (CVD); to determine LDL-C targets recommended by guidelines, and to examine the proportions of patients who do not achieve targeted LDL-C levels in real-world studies.MethodsElectronic databases were searched: Medline, Medline In-Process, Embase, BIOSIS, and the Cochrane Library (1 January 2005 to 31 December 2013). Guideline searches were limited to publications in the last 5 years. There were no geographical or language restrictions.ResultsSeventeen guidelines and 42 observational studies that reported on high-risk hyperlipidaemia patients were identified. The National Cholesterol Education Program–Adult Treatment Panel III’s LDL-C target levels were the most common guidelines used for patients with very high hyperlipidaemia. However, between 68 and 96 % of patients in the studies did not achieve an LDL-C goal <70 mg/dL, except in one study conducted in China (16.9 %). In high-risk patients, 61.8 to 93.8 % did not achieve a target of <100 mg/dL. Regarding common comorbidities, patients with concomitant CVD or diabetes were least likely to reach their target LDL-C goals.ConclusionIn patients with high risk for CVD, the majority of patients do not attain recommended LDL-C goals, highlighting worldwide suboptimal hyperlipidaemia management and missed opportunities for reduction of the patients CVD risk. Lipid-modifying management strategies need to be intensified.

【 授权许可】

CC BY   
© Mitchell et al. 2016