Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in UK primary care - a retrospective database study. Jameson, K., Amber, V., D'Oca, K., Mills, D., Giles, A., & Ambegaonkar, B. International Journal of Clinical Practice, 67(12):1228--1237, December, 2013. doi abstract bibtex AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice. METHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines. RESULTS: At the index date, 98% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2% (sub-group range: 11.0-22.9%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8% to 68.9%, and from 99.2% to 68.7%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0% to 26.9%, whereas that of low HDL-C levels increased, from 16.6% to 18.0%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels. CONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.
@article{jameson_impact_2013,
title = {Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in {UK} primary care - a retrospective database study},
volume = {67},
issn = {1742-1241},
doi = {10.1111/ijcp.12238},
abstract = {AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice.
METHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20\%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines.
RESULTS: At the index date, 98\% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2\% (sub-group range: 11.0-22.9\%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8\% to 68.9\%, and from 99.2\% to 68.7\%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0\% to 26.9\%, whereas that of low HDL-C levels increased, from 16.6\% to 18.0\%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels.
CONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.},
language = {eng},
number = {12},
journal = {International Journal of Clinical Practice},
author = {Jameson, K. and Amber, V. and D'Oca, K. and Mills, D. and Giles, A. and Ambegaonkar, B.},
month = dec,
year = {2013},
pmid = {23944233},
pmcid = {PMC4232237},
keywords = {Adult, Aged, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Dyslipidemias, Female, Great Britain, Humans, Hypolipidemic Agents, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors},
pages = {1228--1237}
}
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{"_id":"35hFkSEjXyfnvjmKy","bibbaseid":"jameson-amber-doca-mills-giles-ambegaonkar-impactoflipidloweringtherapyontheprevalenceofdyslipidaemiainpatientsathighriskofcardiovasculareventsinukprimarycarearetrospectivedatabasestudy-2013","downloads":0,"creationDate":"2017-08-15T09:38:11.982Z","title":"Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in UK primary care - a retrospective database study","author_short":["Jameson, K.","Amber, V.","D'Oca, K.","Mills, D.","Giles, A.","Ambegaonkar, B."],"year":2013,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in UK primary care - a retrospective database study","volume":"67","issn":"1742-1241","doi":"10.1111/ijcp.12238","abstract":"AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice. METHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines. RESULTS: At the index date, 98% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2% (sub-group range: 11.0-22.9%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8% to 68.9%, and from 99.2% to 68.7%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0% to 26.9%, whereas that of low HDL-C levels increased, from 16.6% to 18.0%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels. CONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.","language":"eng","number":"12","journal":"International Journal of Clinical Practice","author":[{"propositions":[],"lastnames":["Jameson"],"firstnames":["K."],"suffixes":[]},{"propositions":[],"lastnames":["Amber"],"firstnames":["V."],"suffixes":[]},{"propositions":[],"lastnames":["D'Oca"],"firstnames":["K."],"suffixes":[]},{"propositions":[],"lastnames":["Mills"],"firstnames":["D."],"suffixes":[]},{"propositions":[],"lastnames":["Giles"],"firstnames":["A."],"suffixes":[]},{"propositions":[],"lastnames":["Ambegaonkar"],"firstnames":["B."],"suffixes":[]}],"month":"December","year":"2013","pmid":"23944233","pmcid":"PMC4232237","keywords":"Adult, Aged, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Dyslipidemias, Female, Great Britain, Humans, Hypolipidemic Agents, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors","pages":"1228--1237","bibtex":"@article{jameson_impact_2013,\n\ttitle = {Impact of lipid-lowering therapy on the prevalence of dyslipidaemia in patients at high-risk of cardiovascular events in {UK} primary care - a retrospective database study},\n\tvolume = {67},\n\tissn = {1742-1241},\n\tdoi = {10.1111/ijcp.12238},\n\tabstract = {AIMS: To estimate the prevalence of dyslipidaemias in high-risk patients new to lipid-modifying therapy (LMT), and establish the extent to which these lipid abnormalities are addressed by treatment in UK clinical practice.\nMETHODS: The PRIMULA study was a retrospective analysis, conducted using the UK General Practice Research Database. Two periods were studied as follows: a pretreatment period, defined as the 12 months before initiation of LMT (the index date), and a follow-up period of at least 12 months. Patients included in the study (n = 25,011) had dyslipidaemia with at least one abnormal lipid measurement [total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) or triglycerides (TG)] in the pretreatment period. All patients were at high risk of cardiovascular events, which was defined as having a history of cardiovascular disease, a 10-year Framingham risk score higher than 20\\%, diabetes or hypertension, as defined by the Joint British Societies 2 guidelines.\nRESULTS: At the index date, 98\\% of patients were initiated on statin monotherapy. After 12 months of treatment, 15.2\\% (sub-group range: 11.0-22.9\\%) of all high-risk patients had no lipid abnormalities. The proportions of patients with high TC or LDL-C levels decreased from 98.8\\% to 68.9\\%, and from 99.2\\% to 68.7\\%, respectively, over 12 months. The prevalence of high TG levels decreased from 45.0\\% to 26.9\\%, whereas that of low HDL-C levels increased, from 16.6\\% to 18.0\\%. Risk factors for cardiovascular events were not consistently associated with the likelihood of attaining optimal lipid levels.\nCONCLUSIONS: Despite widespread use of statins, many individuals at high risk of cardiovascular events have persistently abnormal lipid levels, with over two-thirds of patients not achieving target levels of LDL-C or TC. Management of dyslipidaemia is therefore suboptimal in this important high-risk group in UK standard practice.},\n\tlanguage = {eng},\n\tnumber = {12},\n\tjournal = {International Journal of Clinical Practice},\n\tauthor = {Jameson, K. and Amber, V. and D'Oca, K. and Mills, D. and Giles, A. and Ambegaonkar, B.},\n\tmonth = dec,\n\tyear = {2013},\n\tpmid = {23944233},\n\tpmcid = {PMC4232237},\n\tkeywords = {Adult, Aged, Cardiovascular Diseases, Cholesterol, HDL, Cholesterol, LDL, Cross-Sectional Studies, Dyslipidemias, Female, Great Britain, Humans, Hypolipidemic Agents, Male, Middle Aged, Prevalence, Retrospective Studies, Risk Factors},\n\tpages = {1228--1237}\n}\n\n","author_short":["Jameson, K.","Amber, V.","D'Oca, K.","Mills, D.","Giles, A.","Ambegaonkar, B."],"key":"jameson_impact_2013","id":"jameson_impact_2013","bibbaseid":"jameson-amber-doca-mills-giles-ambegaonkar-impactoflipidloweringtherapyontheprevalenceofdyslipidaemiainpatientsathighriskofcardiovasculareventsinukprimarycarearetrospectivedatabasestudy-2013","role":"author","urls":{},"keyword":["Adult","Aged","Cardiovascular Diseases","Cholesterol","HDL","Cholesterol","LDL","Cross-Sectional Studies","Dyslipidemias","Female","Great Britain","Humans","Hypolipidemic Agents","Male","Middle Aged","Prevalence","Retrospective Studies","Risk Factors"],"downloads":0},"search_terms":["impact","lipid","lowering","therapy","prevalence","dyslipidaemia","patients","high","risk","cardiovascular","events","primary","care","retrospective","database","study","jameson","amber","d'oca","mills","giles","ambegaonkar"],"keywords":["adult","aged","cardiovascular diseases","cholesterol","hdl","cholesterol","ldl","cross-sectional studies","dyslipidemias","female","great britain","humans","hypolipidemic agents","male","middle aged","prevalence","retrospective studies","risk factors"],"authorIDs":[],"dataSources":["FmCWXwJibZiWNzpdc"]}