Adherence to the 2018 AHA cholesterol management guideline in hyperlipidemia treatment among adults in an outpatient setting
Adherence to the 2018 AHA cholesterol management guideline in hyperlipidemia treatment among adults in an outpatient setting
Bahare Behdani,1Toba Kazemi,2Mahmood Zardast,3Saeede Khosravi Bizhaem,4Shima Jafari,5,*
1. Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran, 2. Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran, 3. Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran 4. Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran 5. Department of Clinical Pharmacy, School of Pharmacy, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
Introduction: Although evidence-based guidelines and effective treatments exist
for dyslipidemia, a significant disparity remains between guidelines and clinical
practice. In this study, we investigated adherence to statin therapy per the
2018 ACC/AHA Guideline recommendations
Methods: This is a retrospective, descriptive-analytical study involving 1,224
individuals who presented to the laboratories located in Birjand, Eastern Iran,
from June 2022 to March 2023. Analyses were conducted on 700 patients.
Data collection utilized a checklist and serum value measurements of
laboratory factors deemed necessary for the study
Results: Treatment was administered per the guidelines for 348 out of the
700 patients (49.7%). With 60.7%, the diabetes group exhibited the highest
level of adherence to guidelines. In the atherosclerotic cardiovascular
disease (ASCVD) group, 31.7% followed the recommendations. The lowest
adherence rates were in groups with a 10-year ASCVD risk score of ≥20%
and severe hypercholesterolemia, respectively (0% and 2.8%). In our study,
atorvastatin was the most frequently prescribed statin, with the majority
of patients consuming a moderate-intensity statin. None of the severely
hypercholesterolemic patients achieved the LDL goal. Moreover, LDL-C goal
achievement was low among the ASCVD group and those with an ASCVD risk
score of ≥20%.
Conclusion: Patients with hypercholesterolemia adhere inadequately to the AHA
Guideline. Consequently, training courses are needed to inform medical
doctors, particularly general practitioners, of the latest dyslipidemia treatment
recommendations as the AHA advises
Keywords: statin, AHA Guideline, diabetes, ASCVD, hyperlipidemia