Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update
Background In 2004, the Coordinating Committee of the National Cholesterol Education Program issued an update to the Adult Treatment Panel III guidelines on cholesterol management (the Update). Our objectives were to compare the proportion of elderly patients receiving intensive or minimal-guideline...
Gespeichert in:
| Veröffentlicht in: | The American heart journal 2007-09, Vol.154 (3), p.554-560 |
|---|---|
| Hauptverfasser: | , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 560 |
|---|---|
| container_issue | 3 |
| container_start_page | 554 |
| container_title | The American heart journal |
| container_volume | 154 |
| creator | Nichols, Gregory A., PhD Nag, Soma, PhD Chan, Wiley, MD |
| description | Background In 2004, the Coordinating Committee of the National Cholesterol Education Program issued an update to the Adult Treatment Panel III guidelines on cholesterol management (the Update). Our objectives were to compare the proportion of elderly patients receiving intensive or minimal-guideline lipid-lowering therapy and the proportions meeting low-density lipoprotein cholesterol (LDL-C) goals before and after the update. Methods We used dispense records from Kaiser Permanente Northwest (Portland, OR) to identify elderly patients who received statin therapy in 2003 (n = 14 425) and 2005 (n = 19 422) and laboratory records to assess LDL-C goal attainment. Results Among new statin initiators, 85.4% of very-high-risk patients received minimal-guideline therapy in 2005, compared with 65.3% ( P < .0001) in 2003. Of all new initiators, |
| doi_str_mv | 10.1016/j.ahj.2007.04.037 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68199690</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870307003614</els_id><sourcerecordid>3238313971</sourcerecordid><originalsourceid>FETCH-LOGICAL-c379t-3a15a61678d3299d80ce8860cc13ff9b35e60c624260601ff9924805f69c74fa3</originalsourceid><addsrcrecordid>eNp9kt-KEzEUxgdR3HX1AbyRgOjd1JOZNJMgCEtZtbDogut1SDNn2tQ0qUlG6VP6SqZ_oLIXXoWc_L4v5-RLVb2kMKFA-bv1RK_WkwagmwCbQNs9qi4pyK7mHWOPq0sAaGrRQXtRPUtpXba8EfxpdUG7jsoWppfVn7nP6JPNOxIG4uzW9rULvzFavyR5hVFvd0T7npRi3Z_IgoVtDBmtJ2YVHKaMMTiyDNoRnbO2foM-E70JRxeCrsfodmSBQ4h4MNRDER0OywCMfNHZBl_0s38Mb_rRHOrkLoZl1Bty3Y8uk_uIOh-uuNMeHZnP52Tc9jrj8-rJoF3CF6f1qvr-8eZ-9rm-_fppPru-rU3byVy3mk41p7wTfdtI2QswKAQHY2g7DHLRTrFseMMaDhxoKcmGCZgOXJqODbq9qt4efcs7_BxLv2pjk0HnSj9hTIoLKiWXUMDXD8B1GGMZNCk6BVZ6EEIUih4pE0NKEQe1jXaj405RUPus1VqVrNU-awVMlayL5tXJeVxssD8rTuEW4M0J0MloN0TtjU1nTgrOBWOFe3_ksDzYL4tRJWPRG-xtRJNVH-x_2_jwQG2c9bZc-AN3mM7TqtQoUN_2n3L_J6EDaDll7V_IvN5G</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504616888</pqid></control><display><type>article</type><title>Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Nichols, Gregory A., PhD ; Nag, Soma, PhD ; Chan, Wiley, MD</creator><creatorcontrib>Nichols, Gregory A., PhD ; Nag, Soma, PhD ; Chan, Wiley, MD</creatorcontrib><description>Background In 2004, the Coordinating Committee of the National Cholesterol Education Program issued an update to the Adult Treatment Panel III guidelines on cholesterol management (the Update). Our objectives were to compare the proportion of elderly patients receiving intensive or minimal-guideline lipid-lowering therapy and the proportions meeting low-density lipoprotein cholesterol (LDL-C) goals before and after the update. Methods We used dispense records from Kaiser Permanente Northwest (Portland, OR) to identify elderly patients who received statin therapy in 2003 (n = 14 425) and 2005 (n = 19 422) and laboratory records to assess LDL-C goal attainment. Results Among new statin initiators, 85.4% of very-high-risk patients received minimal-guideline therapy in 2005, compared with 65.3% ( P < .0001) in 2003. Of all new initiators, <1% received very aggressive therapy in either year (0.4% vs 0.3%, P = .315). Overall, 77.7% and 59.0% of ongoing users in 2005 and 2003, respectively, received minimal-guideline therapy ( P < .0001). Low-density lipoprotein cholesterol goal attainment did not differ between 2003 and 2005 continuing statin users. Among very-high-risk patients who initiated statin treatment, a significantly greater proportion of patients in 2005 versus 2003 attained the optional goal of <70 mg/dL (45.5% vs 34.4% P = .014). However, there was no significant difference in the proportion attaining <100 mg/dL (77.8% vs 81.8%, P = .281). Conclusion After the Update, more elderly patients were receiving intensive or minimal-guideline statin therapy. Low-density lipoprotein cholesterol goal attainment was isolated and appeared to occur by shifting already well-controlled patients to lower LDL-C levels. Although these findings may translate into less overall coronary heart disease risk, more aggressive lipid-lowering therapy would likely further reduce risk.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2007.04.037</identifier><identifier>PMID: 17719305</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular disease ; Cholesterol ; Cholesterol, LDL - blood ; Disorders of blood lipids. Hyperlipoproteinemia ; Female ; Heart attacks ; Humans ; Hypercholesterolemia - blood ; Hypercholesterolemia - drug therapy ; Hypolipidemic Agents - therapeutic use ; Male ; Medical research ; Medical sciences ; Metabolic diseases ; Statins</subject><ispartof>The American heart journal, 2007-09, Vol.154 (3), p.554-560</ispartof><rights>Mosby, Inc.</rights><rights>2007 Mosby, Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Limited Sep 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c379t-3a15a61678d3299d80ce8860cc13ff9b35e60c624260601ff9924805f69c74fa3</citedby><cites>FETCH-LOGICAL-c379t-3a15a61678d3299d80ce8860cc13ff9b35e60c624260601ff9924805f69c74fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870307003614$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19866844$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17719305$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nichols, Gregory A., PhD</creatorcontrib><creatorcontrib>Nag, Soma, PhD</creatorcontrib><creatorcontrib>Chan, Wiley, MD</creatorcontrib><title>Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background In 2004, the Coordinating Committee of the National Cholesterol Education Program issued an update to the Adult Treatment Panel III guidelines on cholesterol management (the Update). Our objectives were to compare the proportion of elderly patients receiving intensive or minimal-guideline lipid-lowering therapy and the proportions meeting low-density lipoprotein cholesterol (LDL-C) goals before and after the update. Methods We used dispense records from Kaiser Permanente Northwest (Portland, OR) to identify elderly patients who received statin therapy in 2003 (n = 14 425) and 2005 (n = 19 422) and laboratory records to assess LDL-C goal attainment. Results Among new statin initiators, 85.4% of very-high-risk patients received minimal-guideline therapy in 2005, compared with 65.3% ( P < .0001) in 2003. Of all new initiators, <1% received very aggressive therapy in either year (0.4% vs 0.3%, P = .315). Overall, 77.7% and 59.0% of ongoing users in 2005 and 2003, respectively, received minimal-guideline therapy ( P < .0001). Low-density lipoprotein cholesterol goal attainment did not differ between 2003 and 2005 continuing statin users. Among very-high-risk patients who initiated statin treatment, a significantly greater proportion of patients in 2005 versus 2003 attained the optional goal of <70 mg/dL (45.5% vs 34.4% P = .014). However, there was no significant difference in the proportion attaining <100 mg/dL (77.8% vs 81.8%, P = .281). Conclusion After the Update, more elderly patients were receiving intensive or minimal-guideline statin therapy. Low-density lipoprotein cholesterol goal attainment was isolated and appeared to occur by shifting already well-controlled patients to lower LDL-C levels. Although these findings may translate into less overall coronary heart disease risk, more aggressive lipid-lowering therapy would likely further reduce risk.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cholesterol</subject><subject>Cholesterol, LDL - blood</subject><subject>Disorders of blood lipids. Hyperlipoproteinemia</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hypercholesterolemia - blood</subject><subject>Hypercholesterolemia - drug therapy</subject><subject>Hypolipidemic Agents - therapeutic use</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Statins</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kt-KEzEUxgdR3HX1AbyRgOjd1JOZNJMgCEtZtbDogut1SDNn2tQ0qUlG6VP6SqZ_oLIXXoWc_L4v5-RLVb2kMKFA-bv1RK_WkwagmwCbQNs9qi4pyK7mHWOPq0sAaGrRQXtRPUtpXba8EfxpdUG7jsoWppfVn7nP6JPNOxIG4uzW9rULvzFavyR5hVFvd0T7npRi3Z_IgoVtDBmtJ2YVHKaMMTiyDNoRnbO2foM-E70JRxeCrsfodmSBQ4h4MNRDER0OywCMfNHZBl_0s38Mb_rRHOrkLoZl1Bty3Y8uk_uIOh-uuNMeHZnP52Tc9jrj8-rJoF3CF6f1qvr-8eZ-9rm-_fppPru-rU3byVy3mk41p7wTfdtI2QswKAQHY2g7DHLRTrFseMMaDhxoKcmGCZgOXJqODbq9qt4efcs7_BxLv2pjk0HnSj9hTIoLKiWXUMDXD8B1GGMZNCk6BVZ6EEIUih4pE0NKEQe1jXaj405RUPus1VqVrNU-awVMlayL5tXJeVxssD8rTuEW4M0J0MloN0TtjU1nTgrOBWOFe3_ksDzYL4tRJWPRG-xtRJNVH-x_2_jwQG2c9bZc-AN3mM7TqtQoUN_2n3L_J6EDaDll7V_IvN5G</recordid><startdate>200709</startdate><enddate>200709</enddate><creator>Nichols, Gregory A., PhD</creator><creator>Nag, Soma, PhD</creator><creator>Chan, Wiley, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>200709</creationdate><title>Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update</title><author>Nichols, Gregory A., PhD ; Nag, Soma, PhD ; Chan, Wiley, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c379t-3a15a61678d3299d80ce8860cc13ff9b35e60c624260601ff9924805f69c74fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Cardiovascular disease</topic><topic>Cholesterol</topic><topic>Cholesterol, LDL - blood</topic><topic>Disorders of blood lipids. Hyperlipoproteinemia</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Hypercholesterolemia - blood</topic><topic>Hypercholesterolemia - drug therapy</topic><topic>Hypolipidemic Agents - therapeutic use</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nichols, Gregory A., PhD</creatorcontrib><creatorcontrib>Nag, Soma, PhD</creatorcontrib><creatorcontrib>Chan, Wiley, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nichols, Gregory A., PhD</au><au>Nag, Soma, PhD</au><au>Chan, Wiley, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2007-09</date><risdate>2007</risdate><volume>154</volume><issue>3</issue><spage>554</spage><epage>560</epage><pages>554-560</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background In 2004, the Coordinating Committee of the National Cholesterol Education Program issued an update to the Adult Treatment Panel III guidelines on cholesterol management (the Update). Our objectives were to compare the proportion of elderly patients receiving intensive or minimal-guideline lipid-lowering therapy and the proportions meeting low-density lipoprotein cholesterol (LDL-C) goals before and after the update. Methods We used dispense records from Kaiser Permanente Northwest (Portland, OR) to identify elderly patients who received statin therapy in 2003 (n = 14 425) and 2005 (n = 19 422) and laboratory records to assess LDL-C goal attainment. Results Among new statin initiators, 85.4% of very-high-risk patients received minimal-guideline therapy in 2005, compared with 65.3% ( P < .0001) in 2003. Of all new initiators, <1% received very aggressive therapy in either year (0.4% vs 0.3%, P = .315). Overall, 77.7% and 59.0% of ongoing users in 2005 and 2003, respectively, received minimal-guideline therapy ( P < .0001). Low-density lipoprotein cholesterol goal attainment did not differ between 2003 and 2005 continuing statin users. Among very-high-risk patients who initiated statin treatment, a significantly greater proportion of patients in 2005 versus 2003 attained the optional goal of <70 mg/dL (45.5% vs 34.4% P = .014). However, there was no significant difference in the proportion attaining <100 mg/dL (77.8% vs 81.8%, P = .281). Conclusion After the Update, more elderly patients were receiving intensive or minimal-guideline statin therapy. Low-density lipoprotein cholesterol goal attainment was isolated and appeared to occur by shifting already well-controlled patients to lower LDL-C levels. Although these findings may translate into less overall coronary heart disease risk, more aggressive lipid-lowering therapy would likely further reduce risk.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>17719305</pmid><doi>10.1016/j.ahj.2007.04.037</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 2007-09, Vol.154 (3), p.554-560 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68199690 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Biological and medical sciences Cardiology. Vascular system Cardiovascular Cardiovascular disease Cholesterol Cholesterol, LDL - blood Disorders of blood lipids. Hyperlipoproteinemia Female Heart attacks Humans Hypercholesterolemia - blood Hypercholesterolemia - drug therapy Hypolipidemic Agents - therapeutic use Male Medical research Medical sciences Metabolic diseases Statins |
| title | Intensity of lipid-lowering therapy and low-density lipoprotein cholesterol goal attainment among the elderly before and after the 2004 National Cholesterol Education Program Adult Treatment Panel III update |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T20%3A57%3A36IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Intensity%20of%20lipid-lowering%20therapy%20and%20low-density%20lipoprotein%20cholesterol%20goal%20attainment%20among%20the%20elderly%20before%20and%20after%20the%202004%20National%20Cholesterol%20Education%20Program%20Adult%20Treatment%20Panel%20III%20update&rft.jtitle=The%20American%20heart%20journal&rft.au=Nichols,%20Gregory%20A.,%20PhD&rft.date=2007-09&rft.volume=154&rft.issue=3&rft.spage=554&rft.epage=560&rft.pages=554-560&rft.issn=0002-8703&rft.eissn=1097-6744&rft.coden=AHJOA2&rft_id=info:doi/10.1016/j.ahj.2007.04.037&rft_dat=%3Cproquest_cross%3E3238313971%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1504616888&rft_id=info:pmid/17719305&rft_els_id=S0002870307003614&rfr_iscdi=true |