Nathan D Wong1, Joanna Chuang2, Yanglu Zhao2, Paul D Rosenblit3. 1. Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA. Electronic address: ndwong@uci.edu. 2. Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA. 3. Division of Endocrinology, University of California, Irvine, CA, USA.
Abstract
BACKGROUND: Despite being on treatment, many persons with dyslipidemia still have suboptimal lipid levels and still experience cardiovascular disease (CVD) events. OBJECTIVE: We examined the extent of residual dyslipidemia in terms of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB), in the US population, despite treatment with statin therapy. METHODS: We evaluated the attainment of LDL-C, non-HDL-C, and apoB targets in statin-treated subjects in the National Health and Nutrition Examination Survey 2009-2010. We report on percentage of individuals who attained goal and the mean distance from goal. LDL-C goals were set at <70 mg/dL for those with coronary heart disease, <100 mg/dL for those with other CVDs, diabetes, chronic kidney disease or >20% 10-year CVD risk, <130 mg/dL for those with 10% to 20% 10-year CVD risk or 2+ risk factors, and <160 mg/dL in those with <10% 10-year CVD risk or no more than 1 risk factor. Goals for non-HDL-C were 30 mg/dL higher than corresponding LDL-C goals, and goals of apoB were set to correspond with the same percentile of each LDL-C goal. RESULTS: Of the 5995 US adults aged ≥ 18 years surveyed, 463 (7.7%) were identified as being on a statin-based therapy. Overall, 64% of statin users were at goal for LDL-C, 63% were at goal for non-HDL-C, but only 52% were at goal for apoB. Of those who did not reach goal, 41%, 29%, and 39% were 30% or more from goal for LDL-C, non-HDL-C, and apoB, respectively. Non-Hispanic blacks and those with CVD or diabetes had the highest proportions that were not at goal for LDL-C, non-HDL-C, and apoB. Among those at goal for non-HDL-C, 50% of those with CHD and 33% of other high risk adults were not at ApoB goals. CONCLUSIONS: Despite statin treatment, many persons continue to have residual dyslipidemia with LDL-C, non-HDL-C, and/or apoB levels not being at recommended levels.
BACKGROUND: Despite being on treatment, many persons with dyslipidemia still have suboptimal lipid levels and still experience cardiovascular disease (CVD) events. OBJECTIVE: We examined the extent of residual dyslipidemia in terms of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB), in the US population, despite treatment with statin therapy. METHODS: We evaluated the attainment of LDL-C, non-HDL-C, and apoB targets in statin-treated subjects in the National Health and Nutrition Examination Survey 2009-2010. We report on percentage of individuals who attained goal and the mean distance from goal. LDL-C goals were set at <70 mg/dL for those with coronary heart disease, <100 mg/dL for those with other CVDs, diabetes, chronic kidney disease or >20% 10-year CVD risk, <130 mg/dL for those with 10% to 20% 10-year CVD risk or 2+ risk factors, and <160 mg/dL in those with <10% 10-year CVD risk or no more than 1 risk factor. Goals for non-HDL-C were 30 mg/dL higher than corresponding LDL-C goals, and goals of apoB were set to correspond with the same percentile of each LDL-C goal. RESULTS: Of the 5995 US adults aged ≥ 18 years surveyed, 463 (7.7%) were identified as being on a statin-based therapy. Overall, 64% of statin users were at goal for LDL-C, 63% were at goal for non-HDL-C, but only 52% were at goal for apoB. Of those who did not reach goal, 41%, 29%, and 39% were 30% or more from goal for LDL-C, non-HDL-C, and apoB, respectively. Non-Hispanic blacks and those with CVD or diabetes had the highest proportions that were not at goal for LDL-C, non-HDL-C, and apoB. Among those at goal for non-HDL-C, 50% of those with CHD and 33% of other high risk adults were not at ApoB goals. CONCLUSIONS: Despite statin treatment, many persons continue to have residual dyslipidemia with LDL-C, non-HDL-C, and/or apoB levels not being at recommended levels.
Authors: Nathan D Wong; Yanglu Zhao; Ruben G W Quek; Roger S Blumenthal; Matthew J Budoff; Mary Cushman; Parveen Garg; Veit Sandfort; Michael Tsai; J Antonio G Lopez Journal: J Clin Lipidol Date: 2017-06-30 Impact factor: 4.766
Authors: Vanessa DeClercq; Yunsong Cui; Trevor J B Dummer; Cynthia Forbes; Scott A Grandy; Melanie Keats; Louise Parker; Ellen Sweeney; Zhijie Michael Yu; Roger S McLeod Journal: J Endocr Soc Date: 2017-11-08
Authors: Dirk Müller-Wieland; Lawrence A Leiter; Bertrand Cariou; Alexia Letierce; Helen M Colhoun; Stefano Del Prato; Robert R Henry; Francisco J Tinahones; Lisa Aurand; Jaman Maroni; Kausik K Ray; Maja Bujas-Bobanovic Journal: Cardiovasc Diabetol Date: 2017-05-25 Impact factor: 9.951
Authors: Lawrence A Leiter; Bertrand Cariou; Dirk Müller-Wieland; Helen M Colhoun; Stefano Del Prato; Francisco J Tinahones; Kausik K Ray; Maja Bujas-Bobanovic; Catherine Domenger; Jonas Mandel; Rita Samuel; Robert R Henry Journal: Diabetes Obes Metab Date: 2017-10-10 Impact factor: 6.577