Abstract
We performed a prospective study to assess the acceptability and long-term compliance with drug treatment for hypercholesterolemia in Japanese male workers aged 40 to 57 yr with hypercholesterolemia detected in legally required periodical physical examinations. This paper describes the acceptability of statin-based drug treatment. All eligible workers who had not improved after 3-month diet therapy were recommended for drug treatment with simvastatin, a 3 hydroxy-3-methylcoenzyme A reductase inhibitor. Subsequently, according to each individual preference, the subjects were divided to two groups: a group which accepted drug treatment (DT) and a group which rejected it. The subjects who did not accept drug treatment were further assigned to two groups according to their preference: a group which accepted only dietary intervention (DI) and a non-treatment group (NT). Among 1,278 workers recruited, 656 (51.3%) were placed in the DT group, 414 (32.4%) in the DI group and 208 (16.3%) in the NT group. In the DT group, mean serum total cholesterol (TC) was the highest [272±30 (SD) mg/dl]. The acceptability of drug treatment was significantly associated with the serum TC level, pre-existing medical history of hypertension and a family history of ischemic heart disease (IHD). The occupational issues such as type of job, overtime worked, sleeping time and psychological status were different among the three groups, and habits of taking breakfast and daily exercise were associated with acceptability of drug treatment. These data suggest that acceptability of the drug treatment is low and associated with the work- and lifestyle- related issues as well as IHD risk factors.
