Achieving recommended low density lipoprotein cholesterol goals and the factors associated with target achievement of hypercholesterolemia patients with rosuvastatin in primary care

Abstract

Objective:

Hypercholesterolemia is a major risk factor for cardiovascular disease and requires continuous management. The role of primary physicians in this regard is important, yet the factors associated with successful lipid lowering treatments in primary clinics have not been clearly identified. We aimed to evaluate the rate of successful hypercholesterolemia treatment in Korean primary care, and to identify the factors associated with achieving low density lipoprotein cholesterol (LDL-C) targets.

Methods:

We prospectively recruited and retrospectively assessed 1851 Korean patients with hypercholesterolemia who visited family physicians and were prescribed rosuvastatin for the first time. LDL-C lowering targets, defined according to NCEP ATP III guidelines, were evaluated at 6 months after the first prescription. The factors associated with achieving these targets were also assessed.

Results:

Overall, 87.6% of our participants attained their LDL-C goals. In multiple logistic regression analysis, good adherence to medication was strongly associated with the achievement of target LDL-C levels, whereas higher cardiovascular risk factors including diabetes (in both sexes), low high density lipoprotein, and current smoking status (in males), and hypertension (in females) were related to LDL-C target level failures.

Conclusion:

Our observations of the short period for hypercholesterolemia in Korean primary care has revealed that the rate of achieving target LDL-C levels was high in these patients, whereas patients at higher risk for cardiovascular disease tended to have lower LDL-C achievement outcomes. Primary care physicians should pay more attention to patients showing higher cardiovascular risk and stress the need for good adherence and management regimens in these individuals.

Keywords::

• Achievement
• Framingham risk
• Primary care
• Rosuvastatin
• Target LDL-C

Transparency

Declaration of funding

This study was supported by a grant from AstraZeneca Pharmaceuticals Korea Ltd.

Declaration of financial/other relationships

Y.S.K. has received research grants from AstraZeneca and Daiichisankyo Korea Co. Ltd. J.A.L., S.S., H.J.O., H.-C.K., K.-C.P., D.H.S., S.Y.L., Y.J.Y., B.Y.Y., and C.-M.K. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

This study was supported by a grant from AstraZeneca Pharmaceuticals Korea Ltd. All authors thank Ji Yun Lee for her assistance with the data collection and acknowledge the investigators who participated in this study.

The data from this study has been previously used in: Kim HY, Lee JA, Kim YS et al. Factors of compliance in patients with hypercholesterolemia using rosuvastatin in primary care. Korean J Fam Med 2012;33:253-6129.