The use of lipid-lowering medicatio...

The use of lipid-lowering medication is clearly associated in multiple research studies with reduc coronary heart disease (CHD) morbidity and mortality in patients with known CHD Because arises sometimes vary between controlled trials and real clinical practice, and because identification of particular patient subgroup that benefit would help in resource allocation, a cohort investigation in a clinical setting is useful. Rubins and associates reviewed CHD patient data files at five Veterans Affairs medical facilities, examining time to death from all causes as the primary outcome

Lipid treatment of at least 30 days' duration was noted for 43 percent of the 16470 participants at about time during the 5.9-year follow-up Statins were the principally common therapy, with the majority of patients taking statins also receiving another lipid-lowering medication at a certain number of time during the study. Patients with and without diabetes were equally likely to be prescribed a statin. Fewer lipid-lowering medications were prescribed for older patients.

in succession average, the treated cohort of patients survived 15 month longer than the untreated form into groups There was a significant tendency toward greater benefit among patients with the highest baseline cholesterol values. The relative risk reduction in total mortality athwart six years with the use of lipid-lowering medications was 25 percent similar to that achieved in randomized trials. No clear benefit was noted in the treatment of individuals with diabetes.

The authors finish that lipid-lowering therapy imparts substantial all-cause mortality benefit in bodys with CHD in a clinical setting as it was as that occurring in randomized trials. The riddle of undertreatment in older patients is disturbing, because the obtainable absolute risk reduction achieved with treatment of this form into groups is higher than that of a younger assign places to The relative benefit of lipid-lowering medications in human frames with CHD who have relatively normal on a levels of cholesterol remains less certain. The absence of increased benefit in treated [i]role[/i]s with diabetes may result from the use of all-cause mortality as an finis point rather than using major coronary ends as the examined outcome.

Rubins HB et al. Effectiveness of lipid-lowering medications in outpatients with coronary heart disease in the Department of Veterans Affairs hypothesis Am J Cardiol November 15 2003;92:1177-82

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