[Regional differences in the treatment of dyslipidemia in Germany]

Dtsch Med Wochenschr. 2011 Mar;136(11):512-8. doi: 10.1055/s-0031-1274534. Epub 2011 Mar 8.
[Article in German]

Abstract

Background and objective: DYSIS (Dyslipidemia International Study) is an international multicenter cross-sectional trial. The objective of the regional analysis was to identify differences in lipid-lowering therapy and attainment of goal/normal lipid levels in Germany.

Methods: 4,260 patients who were at least 45 years of age and receiving regular statin therapy at 748 centers (office practices / outpatient clinics) in Germany were assessed at a routine ambulant appointment. Results from centers in the northern, eastern, southern, and western part of Germany were compared.

Results: The mean age of the patients was 66.6 - 67.9 years (p < 0.01, range over the four regions) and the proportion of males was 53 - 60 % (p < 0.01). There were significant regional differences in the number of cardiovascular risk factors and cardiovascular conditions, e. g. arterial hypertension (82 - 88 %), smoking (12 - 17 %), family history of coronary heart disease (CHD) (30 - 42 %), lack of exercise (38 - 48 %), CHD (only in women, 27 - 42 %), peripheral artery vascular disease (11 - 15 %), and heart failure (16 - 20 %). No regional differences were found for body mass index (BMI), waist circumference, metabolic syndrome, or diabetes mellitus. The mean LDL-cholesterol level in the four regions was 107 - 108 mg/dl (p = 0.53), HDL-cholesterol was 50 - 51 mg/dl (p = 0.62), and triglycerides 141 - 148 mg/dl (p = 0.68). The mean simvastatin (or simvastatin-equivalent) dosage was approximately 27 mg/day (p = 0.62). About half of the patients (49 - 53 %, p = 0.11) failed to attain their LDL-cholesterol target despite statin therapy. In addition to elevated LDL-cholesterol, 30 % of the patients had elevated triglycerides and/or low HDL-cholesterol.

Conclusion: DYSIS showed the existence of significant regional differences in the characteristics of statin-treated patients but not in the type or dosage of statin therapy or in adherence to target/normal lipid levels as per guidelines. In a high proportion of patients the lipid-lowering therapy will need to be reviewed, as guideline target levels have not been attained.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Anticholesteremic Agents / therapeutic use*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Clinical Protocols / standards*
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Male
  • Metabolic Syndrome / drug therapy*
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Risk Factors

Substances

  • Anticholesteremic Agents
  • Cholesterol, HDL
  • Cholesterol, LDL