Abstract
BackgroundImplementing evidence-based management of dyslipidaemia is a challenge worldwide.ObjectivesTo understand physician beliefs and behaviour and identify uncertainties in dyslipidaemia management across four world regions.MethodsWeb-based survey of 1758 physicians in Japan, Germany, Colombia and the Philippines who were selected randomly from existing databases. Key inclusion criteria were 1) for cardiologists and diabetes/endocrinology specialists: ≥50 dyslipidaemia patients examined in the last month; 2) for specialists in neurology/neurosurgery/stroke medicine: ≥50 dyslipidaemia patients and ≥ 20 patients with a history of ischaemic stroke examined in the last month; and 3) for specialists in nephrology and general medicine: based at centres with ≥20 beds and ≥ 50 dyslipidaemia patients examined in the last month. The self-report survey covered dyslipidaemia management, target low-density lipoprotein cholesterol (LDL-C) levels in different patient groups, and statin safety. All physicians gave voluntary consent and all data were anonymised. Analysis was solely descriptive.ResultsThe survey highlighted key areas of uncertainty in dyslipidaemia management in the four countries. These related to LDL-C targets in different patient groups, the safety of low LDL-C levels, the safety of statins, especially for effects on cognitive, renal and hepatic function and for haemorrhagic stroke risk, and lipid management strategies in patients with chronic kidney disease, including those with concomitant hypertriglyceridaemia.ConclusionsThis survey of physicians in Japan, Germany, Colombia and the Philippines has identified key gaps in knowledge about dyslipidaemia management. These relate to the safety of low LDL-C levels, the safety of statins, and lipid management of chronic kidney disease. The findings from this survey highlight the need for further education to improve the implementation of guideline recommendations for dyslipidaemia management.
Highlights
Extensive and robust evidence has established lowdensity lipoprotein cholesterol (LDL-C) as causal for atherosclerotic cardiovascular disease (ASCVD) [1]
This survey of physicians in Japan, Germany, Colombia and the Philippines has identified key gaps in knowledge about dyslipidaemia management. These relate to the safety of low LDL-C levels, the safety of statins, and lipid management of chronic kidney disease
The findings from this survey highlight the need for further education to improve the implementation of guideline recommendations for dyslipidaemia management
Summary
Extensive and robust evidence has established lowdensity lipoprotein cholesterol (LDL-C) as causal for atherosclerotic cardiovascular disease (ASCVD) [1]. Irrespective of therapeutic strategy, lowering LDL-C levels reduces the risk of ASCVD events, as demonstrated in major cardiovascular outcomes studies in very high-risk patients treated with a statin [2] or non-statin therapy (i.e. ezetimibe or proprotein convertase subtilisin/kexin type 9 [PCSK9] inhibitors) [3,4,5]. The safety of these LDL-lowering therapies has been demonstrated [2,3,4,5]. Implementing evidence-based management of dyslipidaemia is a challenge worldwide
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