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Half the people prescribed statins do not achieve cholesterol targets after two years, says the study



The researchers used data provided to British clinical practice to research data from 681 family doctors. The study group was composed of 165,411 people who were prescribed statins between 1990 and 2016 and who were not treated for heart disease or pre-stroke stroke.

They defined an "appropriate" response to statin therapy as a 40% or more reduction in LDL or "bad" cholesterol, as recommended by the UK National Institute of Health and Care.

Less than half of all people enrolled during the 26-year study period – 48.8% – achieved a targeted cholesterol level of the two-year follow-up sign, with just over half-51.2% decreasing, according to the study, published in Monday in the journal "Heart".

Having considered differences in age and underlying medical conditions, the researchers found that people who did not lower their LDL cholesterol had a 22% greater likelihood of developing cardiovascular disease than those who reduced it.

Statins work by reducing LDL-cholesterol or low-density lipoprotein, which in turn reduces the risk of heart attack and strokes. In the United States, the American Heart Association and the American College of Cardiology recommend that doctors use a calculator for 10 years to determine which patients can benefit from such therapy.
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According to the 78 US Centers for Disease Control and Prevention, over 78 million Americans, or just over one third of all adults, have the right to statin therapy or take statins. In the UK, over 7 million adults take these drugs, according to the British Heart Foundation.

The number of Americans who do not reach levels of target cholesterol after starting the statin is probably similar to the findings of the study, explains Dr. David Fishman, a professor of medicine and co-director of the Laboratory for Cardiac Catheterization at University Hospital Thomas Jefferson, who was not are included in the study.

"To care for patients, treat them with statins, it's work, lots of things, it's not easy, it's a temporary commitment to achieve," Fishman said. "When you start someone with cholesterol drugs, you need to check their cholesterol for four to 12 weeks, then make adjustments, which emphasizes the importance of doing this."

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In addition to the workload and dedication needed to optimize cholesterol levels, the authors explain that genetic factors and differences in adherence to prescribed regimens can explain some of the variations in response to statin recipes, and they call for "personalized" drugs.

"At present, there is no management strategy in clinical practice that takes account of patient variations in [low density cholesterol] response and no guidelines for predictive screening before starting with static therapy, "the researchers said.

In the editorial staff published together with the study in the heart, Dr Marci Bitencourt, a cardiologist at the Sao Paulo Hospital in Brazil, explains that the doctor's treatment practices may also reveal some of the differences seen in the research. Those who have achieved cholesterol targets are more likely to be prescribed more potent statins, probably because the group also started with higher levels of cholesterol, he said.

The research has several limitations. As an observational study, it can not establish a cause and effect. The exact dose of prescribed statins and the compliance of patients with prescriptions were not within the scope of the research.

"The message of taking home for me is, we have to do a good job. We have to follow, not only the doctor, but also the patient," Fishman said. "Because if not, [patients who don’t reach target cholesterol levels] they will not ride. "


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