Persistent dyslipidemia in statin-treated patients: the focus on comprehensive lipid management survey in Swiss patients

• Published in: Swiss medical weekly 2011, Vol.141 (1920), p.w13200-w13200
• Main Authors: Sudano, Isabella, Hess, Lorenzo, Noll, Georg, Arnet, Diana
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular Diseases - epidemiology; cardiovascular risk; Cholesterol, HDL - blood; Cholesterol, LDL - blood; Cross-Sectional Studies; Dyslipidemias - blood; Dyslipidemias - drug therapy; Dyslipidemias - epidemiology; Female; HDL-Cholesterol; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; LDL-Cholesterol; lipid profile; Male; Middle Aged; Prevalence; Risk Factors; Sex Factors; Statin; Switzerland - epidemiology; Triglycerides; Triglycerides - blood
• ISSN: 1424-7860; 1424-3997
• DOI: 10.4414/smw.2011.13200

Statin therapy reduces cardiovascular morbidity and mortality. However, a substantial residual cardiovascular risk can be observed in patients receiving this therapy due to persisting lipid abnormalities as well as to the lack of a systematic global risk-reduction strategy. The objective of the study was to assess the prevalence of dyslipidemia in a cohort of patients living in Switzerland and receiving statin therapy. This cross-sectional study was conducted by 61 primary care physicians, cardiologists, endocrinologists and internists in Switzerland. Patients were consecutive outpatients≥45 years-old, on statin therapy for at least 3 months with available lipid values. A clinical examination and a recording of the latest lipid values on statin therapy were performed in all patients. A total of 473 patients (age 66.3±9.41 years; 61.9% male) were included in the final analysis. Under statin therapy, 40% of the analysed patients had a normal lipid profile, 32.6% presented increased low-density lipoprotein cholesterol (LDL-C) (3.35±0.88 mmol/L), 28.8% low high-density lipoprotein-cholesterol (HDL-C) (0.95±0.18 mmol/L) and 31.1% elevated triglycerides (2.69±1.04 mmol/L). It is of note that the included population was characterised by a high prevalence of cardiovascular risk factors (86.5% patients had 10-year cardiovascular risk>20%). Nevertheless, the lipid lowering therapy was modified in only 15.4% of the patients. Persistent dyslipidemia is a reality in statin-treated patients and may contribute to their residual cardiovascular risk. Therefore, comprehensive lipid management should be preferred to aggressive LDL-C lowering alone. Moreover, strategies to assess and modify the global cardiovascular risk of patients should be taken into account as an important component of primary and secondary prevention.