Abstract
The anti-atherosclerotic effects of lipid-lowering therapy have not been clarified, either in Japan or in the West. The Japan Atherosclerosis Society's guidelines for hyperlipidemia patients were initially published in 1997 based on epidemiologic studies, following by revised guidelines in 2002 based on some non-randomized clinical studies. We investigated the current status of lipid-lowering therapy in Iwate prefecture by random sampling method after publication of these guidelines. In order to ascertain achievement rates of target levels recommended in the Japan Atherosclerosis Society's guidelines, we investigated clinical profiles in patients with hypercholesterolemia who received lipid-lowering agents. Subjects were 823 randomly selected patients (257 men and 566 women). Statins were the most frequently used agents (84.1%), high dose statins were used in 6.9% of patients and a combination of two more drugs was administered in 13.8% of patients. Excluding familial hypercholesterolemia, the attainment rate of treatment target levels for total cholesterol were 54.2% overall, 57.0% in patients without coronary heart disease but with other risk factors (category B) and 26.0% in patients with coronary heart disease (category C). The attainment rates of treatment target levels for low-density lipoprotein cholesterol (LDL-C) were 64.4% overall, 67.0% in category B and 31.0% in category C. The attainment rates of treatment target levels for high-density lipoprotein cholesterol (HDL-C) were 70.9% overall, and the attainment rates of triglyceride treatment target levels were 63.7% overall. These findings revealed that the current attainment rates achieved by lipid-lowering therapy are higher than those before new guidelines were published, due to the use of new powerful statins. However it remains uncertain whether more aggressive lipid-lowering therapy will be needed in Japan, since the anti-atherosclerotic effects of lipid-lowering therapy in Japanese patients are not yet established.
