Utilisation of lipid-lowering therapies in outpatient settings in Poland: epidemiological survey Economedica Dyslipidaemia 2015.

BACKGROUND: Dyslipidaemia, especially elevated low-density lipoprotein cholesterol (LDL-C), is one of the most important cardiovascular risk factors. Treatment of dyslipidaemia and prevention of cardiovascular disease (CVD) with lipid-lowering drugs is one of the key issues in reducing cardiovascular mortality. Nevertheless, underutilisation of statins and lipid-lowering drugs is still a problem globally.

AIM: The present study aimed to describe the utilisation of lipid-lowering drugs in groups of patients with indications for statin treatment and elevated LDL-C.

METHODS: The study included adult patients with an indication for the use of a lipid-lowering therapy, currently using or not using such therapy because of contraindications or statin intolerance, in whom LDL-C concentration was > 70 mg/dL, treated in outpatient settings. All patients were screened for CVD and had blood cholesterol concentration assessed. Patients were also divided into: (1) patients with vascular disease; (2) patients with diabetes mellitus; (3) aged ≥ 65 years; and (4) patients without the three mentioned risk factors.

RESULTS: The study group consisted of 2812 (51.4% male) patients. Major cardiovascular risk factors including arterial hyper-tension, type 2 diabetes mellitus, and smoking were highly prevalent in the study population (86.2%, 44.1%, and 23.3%, respectively). Out of the prespecified risk factors (vascular disease, diabetes mellitus, age ≥ 65 years) the study population was divided into patients without any of the mentioned risk factors (n = 520), those with all the three risk factors (n = 368), two out of three risk factors (n = 934), and one risk factor (n = 990). The study showed that 89.6% of patients were treated with statins (47.8% with atorvastatin, 27.8% with rosuvastatin, and 13.8% with simvastatin). Fenofibrate was used in 5.8% of the population and ezetimibe in 2.7%. In the whole group, 7.1% of patients did not receive any type of lipid-lowering therapy. Atorvastatin was more often used in patients with all the three prespecified risk factors, while rosuvastatin was used in patients without any of the risk factors.

CONCLUSIONS: The most often-used lipid-lowering drugs in Poland are statins, with atorvastatin and rosuvastatin being used the most common of these. The present study shows that some patients with LDL-C concentration > 70 mg/dL and indications for lipid-lowering are not treated accordingly.