Appropriateness of cholesterol management in Swiss clinical practice

Summary The aim of this prospective study was to evaluate the appropriateness of cholesterol management in Swiss clinical practice according to the recommendations of Swiss Society of Cardiology. 99 office-based physicians participated in this survey in order to provide questionnaire reporting demographic and clinical data for every adult consulting each physician during five consecutive days. Questionnaires were obtained for 8791 patients (55% of women) with mean age of 56 ± 18 years. Among them, 63% were screened for total cholesterol, 49% for triglycerides, 39% for HDL-cholesterol and only 21% for LDL-cholesterol. Cardiac (CHD) risk category and age over 50 years were good predictors of lipid screening. Among eligible patients, only 34% of women and 55% of men received lipid-lowering agents in the high risk group, whereas this proportion was much more lower in moderate and low risk groups. Furthermore, among treated patients, the mean level of cholesterol was higher than ideal (<5.0 mmol/L), even in the high risk group (7.2 ± 1.0 and 6.9 ± 1.4 mmol/L), respectively for women and men. According to Evidence-Based Medicine, these results clearly indicate a missed opportunity for detection and treatment of patients with increased cardiovascular risk. Such data require to promote the quality of cholesterol management in clinical practice.