English summary: REACHING THE GOALS FOR THE TREATMENT OF DYSLIPIDEMIA IN 2000 AND 2005: HAS THERE BEEN ANY PROGRESS?

Background Treatment of dyslipidemia is being initiated more often than previously. Coronary and other endpoints are more likely to be prevented if the goals of dyslipidemia treatment are achieved.

Methods In this study we compared the achievement of treatment goals in dyslipidemic outpatients in 2000 and 2005. In both years the participating physicians on the outpatient ward were given a validated measuring device (Cholestech) for the evaluation of the lipid profile of patients treated with lipid lowering medication.

Results There has been some positive development between 2000 and 2005, but a significant number of dyslipidemia patients have still not reached their treatment goals despite medication. The LDL-cholesterol level was over the recommended 2.5 mmol/l in as many as 45% of patients with coronary artery disease who were using medication. In 2000, 24% of the physicians considered that target LDL-cholesterol should be below 2.5-2.6 mmol/l, whereas in 2005 the number was 45%. Multiple variable analysis showed that the chances of reaching the target level of LDL-cholesterol were improved if the physician (OR 2.3; 95% CI 1.7-3.3) and the patient (OR 1.6; 95% CI 1.1-2.2) had a positive attitude to the treatment, as well as with efficient treatment of dyslipidemia (atorvastatin or rosuvastatin, or a combination of a statin and ezetimibe; OR 1.8; 95% CI 1.3-2.5).

Conclusions The treatment of dyslipidemia still needs to be intensified. The target levels are achieved best if both the patient and the physician are active and the doses of lipid-lowering medication are adjusted according to the response and efficient medication is used when needed.