More patients across the world lowering 'bad' cholesterol

Study Highlights:

* More people in the past decade have lowered their level of “bad” LDL cholesterol to acceptable ranges.
* In the United States, the overall compliance rate of LDL at target levels has nearly doubled since 1996.
* About one third of high-risk patients still need to attain LDL goals through adequate treatment.

The percentage of patients lowering their elevated “bad” cholesterol to within target levels nearly doubled in the last decade, according to a multi-national survey reported in Circulation: Journal of the American Heart Association.

In the Lipid Treatment Assessment Project (L-TAP) 2 — a survey of nearly 10,000 patients (average age 62) from nine countries undergoing cholesterol-lowering and management efforts — researchers found that:

* The number of patients successfully reaching their respective low-density lipoprotein (LDL) levels rose from 38 percent to 73 percent over the last 10 years.
* Among high-risk patients, 67 percent reached established goal levels.
* Only 30 percent of very high risk patients — those with existing coronary artery disease and two or more other risk factors such as obesity, diabetes and smoking — successfully reached their LDL target of 70 milligrams per deciliter (mg/dL) or less.

LDL is known as “bad” cholesterol because it’s associated with increased cardiovascular risk.
“Although there is room for improvement, particularly in very high-risk patients, these results indicate that lipid-lowering therapy is being applied much more successfully than it was a decade ago,” said David D. Waters, M.D., lead author of the study and Emeritus Professor, University of California, San Francisco.

Researchers examined compliance with LDL goals outlined in the National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III, the 2003 Joint European Societies, or the 2003 Canadian Working Group. Countries in the study were the United States, Canada, Mexico, the Netherlands, Spain, France, Brazil, South Korea and Taiwan.

LDL cholesterol goals in the United States depend on how many risk factors are present, according to NCEP ATP III guidelines:

* For people without coronary heart disease, diabetes or cardiovascular risk factors, the goal is less than 160 mg/dL.
* For people without coronary heart disease or diabetes, but who have two or more cardiovascular risk factors, the goal is less than 130 mg/dL.
* For patients with coronary heart disease or diabetes, the goal is less than 100 mg/dL. But when risk is very high, a goal of less than 70 mg/dL is a therapeutic option.

Researchers found that 75 percent of the patients surveyed were taking a statin drug (atorvastatin, simvastatin, rosuvastatin or pravastatin). The median duration of therapy was two years. Others were treated with fibrates, ezetimbe or lifestyle changes such as diet and exercise alone.