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Attainment of Normal Lipid Levels Among Patients on Lipid-Modifying Therapy in Hong Kong

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Abstract

Introduction

Although low-density lipoprotein cholesterol (LDL-C) is the primary lipid target for coronary heart disease (CHD) risk reduction, high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG) have also emerged as CHD risk factors. The objective of this study was to evaluate attainment of lipid goals and normal levels following lipid-modifying therapy (LMT) and its predictors in a representative sample of Chinese patients from Hong Kong.

Methods

Using longitudinal data collected from patient medical records, the study identified 706 patients who initiated LMT from January 2004 to December 2006 and had full lipid panels 12 months before and after therapy. LDL-C goals and normal levels of HDL-C and TG were defined according to the National Cholesterol Education Program Adult Treatment Panel 3 guidelines. Patients with previous CHD, diabetes, and 10-year CHD risk > 20% were classified as high risk. Multiple logistic regressions evaluated predictors of normal lipid-level attainment.

Results

Among 706 patients (mean age 64.6 years, 58.6% male), 71.7% had elevated LDL-C, 32.4% had low HDL-C, and 24.9% had elevated TG before LMT. Despite therapy (91.2% statins only), 22.7% had elevated LDL-C, 31.9% had low HDL-C, 12.3% had elevated TG, and 13.9% had multiple abnormal lipid levels. The strongest predictors of attaining ≥ 2 normal lipid levels included male gender (odds ratio [OR]: 2.11 [1.12 to 4.01]), diabetes (OR: 0.43 [0.23 to 0.78]), obesity (OR: 0.91 [0.86 to 0.97]), and CHD risk > 20% (OR: 0.33 [0.15 to 0.71]).

Conclusions

Current approaches to lipid management in Hong Kong, primarily using statins, considerably improve attainment of LDL-C goal. However, a large proportion of patients do not achieve normal HDL-C levels and control of multiple lipid parameters remains poor. Patients could benefit from a more comprehensive approach to lipid management that treats all three lipid risk factors, as suggested in clinical guidelines.

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Authors and Affiliations

  1. Global Outcomes Research, Merck & Co., Inc., One Merck Drive, P.O. Box 100, WS 2E-65, Whitehouse Station, NJ, 08889, USA

    Baishali Ambegaonkar & Vasilisa Sazonov

  2. University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Diana Chirovsky

  3. The University of Hong Kong, Hong Kong, China

    Hung Fat Tse

  4. Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong, China

    Yuk Kong Lau & Prabowo Tunggal

  5. The Chinese University of Hong Kong, Hong Kong, China

    Brian Tomlinson

  6. Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    Shu Kin Li & Man Chun Choi

  7. United Christian Hospital, Hong Kong, China

    Chiu Sun Yue & Tai Hung Wong

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  1. Baishali Ambegaonkar
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  2. Diana Chirovsky
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  3. Hung Fat Tse
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  4. Yuk Kong Lau
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  11. Vasilisa Sazonov
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Correspondence to Baishali Ambegaonkar.

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Ambegaonkar, B., Chirovsky, D., Tse, H.F. et al. Attainment of Normal Lipid Levels Among Patients on Lipid-Modifying Therapy in Hong Kong. Adv Therapy 29, 427–441 (2012). https://doi.org/10.1007/s12325-012-0017-9

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  • DOI: https://doi.org/10.1007/s12325-012-0017-9

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