Cholesterol: 50% of patients don't achieve target

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A South African study finds that almost 50% of patients are not achieving their cholesterol target and so increase their risk of another cardiovascular event in their next 10 years.

Cardiovascular disease (CVD) is the second leading cause of death in South Africa. The relationship between increased LDL-Cholesterol (LDL-C) levels and increased risk of cardiovascular disease is widely accepted – lowering LDL-C levels reduces coronary heart disease mortality. 

Treatment of cholesterol and cardiovascular disease focuses on LDL-C reduction as a primary target.

Patients with high LDL-C levels are usually treated with lipid lowering medication to lower their LDL-C to reach their treatment goal. In South Africa it is estimated that at least over a million people are treated with lipid lowering medication.

A large clinical trial in South Africa investigated the percentage of patients on treatment with lipid lowering medication that were actually achieving LDL-C goal.  Many of the patients involved in the study had a medical history of high blood pressure, diabetes and cardiovascular disease.  They were receiving lipid lowering medication to lower their cholesterol to their LDL-C treatment target.

Most patients in the study were informed of their cholesterol level and 80% had been given a LDL-C target.  Most were aware of the role of LDL-C in CVD risk and were satisfied with the level of information provided by their physicians.

Despite this, the study highlighted that almost 50% of patients on cholesterol lowering medication were not achieving their LDL-C goal – i.e. they were not at the target LDL-C level required to maximally decrease their risk of having a further event. 

Certain factors were associated with this:

• People with diabetes, non-smokers, and older people were more likely to achieve goal
• A person’s weight did not affect whether or not they achieved target
• Compliance with treatment, including compliance once LDL-C had returned to normal levels was a key factor in ensuring a patient reached goal

If you have had a cardiovascular event please ensure that you have your LDL- Cholesterol checked twice a year and make sure your level is kept below 1.8 mmol/l. If it isn’t, talk to your doctor about what you should do to get to 1.8 or lower.