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Improving lipid profiles and increasing use of lipid‐lowering therapy in England: results from a national cross‐sectional survey – 2006
Author(s) -
Mindell Jennifer,
Aresu Maria,
Zaninotto Paola,
Falaschetti Emanuela,
Poulter Neil
Publication year - 2011
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2011.04094.x
Subject(s) - medicine , diabetes mellitus , cross sectional study , cholesterol , population , lipid profile , endocrinology , demography , environmental health , pathology , sociology
Summary Objective To evaluate blood lipid levels in the adult English population in 2006 and to report change in the use and efficacy of lipid‐lowering treatment since 2003 after which time the general practitioner contract introduced a ‘pay‐per‐performance’ approach. Design Cross‐sectional surveys. Participants Nationally representative sample of 14 142 noninstitutionalized adults (>16 years) living in England, partaking in the Health Survey for England 2006. Measurements Mean levels of total, HDL, non‐HDL and total/HDL cholesterol ratio, prevalence of hypercholesterolaemia, use of lipid lowering agents and lipid levels and control rates among those on treatment. Results Age‐standardized mean cholesterol levels fell from 5·49 m m in men and 5·56 m m in women in 2003 to 5·26 and 5·37 m m , respectively, in 2006. In 2006, 59% of adults had a total cholesterol ≥5·0 m m and 11% reported lipid‐lowering treatment, of whom 66% had a total cholesterol <5·0 m m and 22% were <4·0 m m . The majority of those with established coronary heart disease, stroke or diabetes but fewer than one quarter of those with hypertension or ≥20% estimated 10‐year cardiovascular risk and no established CVD took lipid‐lowering drugs. Lipid lowering treatment rates increased fivefold and control rates among the treated (to <5·0 m m ) more than doubled between 1998 and 2006. About one‐third of those with established CVD or diabetes had cholesterol levels of <4·0 m m . Conclusions Previously reported improvements in treatment and control rates between 1998 and 2003 continued between 2003 and 2006, with the biggest increases among those with established CVD and diabetes.