부산대학교 도서관

BACKGROUND : The results from clinical studies with statins have directed attention to the benefits of risk factor intervention in atherosclerotic disease, and achievement of treatment goals for blood lipids.MATERIAL AND METHODS : In 1999, a total of 3,935 patients treated with a statin were screened in 412 general practices in Norway for their blood lipids, in order to evaluate the achievement of the new European treatment guidelines (total cholesterol < 5 mmol/l and LDL cholesterol < 3 mmol/l). Inclusion criterion was ongoing medication with a statin, independent of indication. Consecutive patients were interviewed and examined when they attended their regular check-ups. The mean age of the patients was 63 years; 42% of them were women. Two-thirds of the patients were in secondary prevention.RESULTS : Before treatment, the mean level of total cholesterol was in primary prevention 8.8 mmol/l, in secondary prevention and in diabetes 7.5 mmol/l. In the total material, 36% of the patients achieved the treatment goal of total cholesterol and LDL cholesterol. Significantly more patients in secondary prevention than in primary prevention achieved the treatment goal (44% versus 17%), more patients with than without diabetes achieved it (45% versus 34%), and more men than women (42% versus 27%). These differences were mainly due to differences in base levels of total cholesterol and LDL cholesterol. To assess the statin doses, the average dose of each type of statin was converted to a simvastatin dose. The average dose in this manner was found to be 23.8 mg, with small differences between the subgroups.INTERPRETATION : The doctors did not uptitrate the statin doses according to the lipid levels and in line with the evidence from the clinical trials. General practitioners in Norway should intensify their use of lipid lowering therapy.