MUNICH, Germany, September 2 /PRNewswire/ --
-- In spite of the success of therapies targeting LDL in lowering cardiovascular risk, a residual risk still remains
Cardiologists in Europe agree that reducing LDL-cholesterol (LDL-C or "bad" cholesterol) levels is the most important factor in treating dyslipidemia (abnormal blood lipids) and reducing the risk of a cardiovascular event. A majority of cardiologists also agree that in addition to lowering LDL-C, raising HDL-cholesterol (HDL-C or "good" cholesterol) and reducing triglycerides are important targets in reducing cardiovascular risk. Yet, despite these views, physicians are only treating one-third of their cardiovascular disease patients based on all three lipid parameters. These findings, from a new TNS Healthcare survey sponsored by Merck Sharp & Dohme (MSD), were presented today at the 2008 European Society of Cardiology (ESC) Annual Congress.
"Established clinical evidence on the value of reducing LDL-C has driven the management of dyslipidemia over the past two decades, resulting in a significant reduction in cardiovascular disease mortality," said Anselm Kai Gitt, M.D., Vice Director of the Myocardial Infarction Research Institute in Ludwigshafen, Germany. "Despite these great strides, significant cardiovascular risk remains for patients who have lowered their LDL-C levels through lifestyle modification and medication. When treating a patient, we must consider all risk factors including low HDL-C and triglycerides, among others, and recommend appropriate intervention."
Research shows that lowering LDL-C with statin therapy may decrease the risk of cardiovascular disease by about 25 to 40 percent. Other factors that contribute to cardiovascular risk include low levels of HDL-C, high levels of triglycerides, hypertension, diabetes, and obesity. According to the survey results, more than two-thirds of cardiologists agree that despite lowering LDL-C levels, a residual risk for cardiovascular events remains.
Gap between perception and practice in factors for treating dyslipidemia
According to the survey results, 97 percent of respondents said reducing LDL-C is a "fairly" or "extremely" important consideration when choosing a treatment for dyslipidemia, and 84 percent said they consider increasing HDL-C as either "fairly" or "extremely" important. However, less than half (47 percent) of their patients are treated for both of these lipids. Moreover, 66 percent said reducing triglycerides is either "fairly" or "extremely" important. Only 29 percent of their patients, however, are treated based on all three lipid parameters, despite the majority acknowledging that all three lipids are risk factors for cardiovascular disease.
Cardiologists placed the greatest emphasis on LDL-C reduction and lifestyle education. Even though 89 percent of cardiologists surveyed agree that HDL-C is an important contributor to cardiovascular disease, 10 percent or less believe that educating patients on raising their good cholesterol is important.
"These findings reveal a strong belief in the importance of treating beyond LDL-C alone to reduce the residual risk of cardiovascular events in patients with dyslipidemia, yet this is not adequately translating into clinical practice," said Dr. Gitt. "Cardiologists are in a unique position to change this paradigm. Armed with scientific knowledge, clinical experience and new treatment advances, we can establish a comprehensive approach to cardiovascular disease management."
About the survey
TNS Healthcare conducted an online questionnaire of a total of 507 cardiologists in France (n=101), Germany (n=100), Italy (n=100), Spain (n=106), and the UK (n=100) between June 18 and July 30, 2008. Cardiologists' practices ranged from hospital-based to office-based to both hospital- and office-based in primarily urban areas.
Impact of three major lipids on cardiovascular risk factors
Cardiovascular disease (CVD) is a general term referring to diseases that affect the heart or blood vessels. Coronary heart disease (CHD), also known as coronary artery disease (CAD), is one of the most common forms of CVD and is the leading cause of death globally. Major risk factors for CVD include abnormal blood lipids, meaning not only high LDL-C levels but also high levels of triglycerides and low levels of HDL-C.
CVD is the main cause of death in Europe, accounting for more than 4.9 million deaths (52 percent of all mortality) in 2002. Nearly half of all deaths from CVD are from CHD (48 percent) and nearly one-third are from stroke (29 percent). CHD by itself is the most common cause of death in Europe, accounting for nearly 2.4 million deaths each year.
Cholesterol is one of several fatty substances (lipids) found in the bloodstream. Total cholesterol is made up mainly of LDL-C and HDL-C. LDL-C is often called "bad" cholesterol because it can build up in the walls of the arteries and form plaque. Over time, the plaque can clog the arteries, resulting in a heart attack or stroke. HDL-C is often called "good" cholesterol because it is thought to keep LDL-C from building up in the arteries, and because it appears to protect against heart disease in other ways as well. Triglycerides are another form of fat in the blood, and elevated levels may also raise the risk of developing heart disease. The Pan-European Survey (2005) found that about one-third of men and 40 percent of women have low HDL-C levels, regardless of the use of lipid-modifying treatment (primarily statins). Low HDL-C in combination with high triglycerides is also common across Europe, where 22 percent of men and 25 percent of women have abnormal levels of both lipids.
Merck & Co., Inc. (Whitehouse Station, N.J., U.S.A.), which operates in many countries as Merck Sharp & Dohme or MSD, is a global research-driven pharmaceutical company dedicated to putting patients first. Established in 1891, the Company currently discovers, develops, manufactures and markets vaccines and medicines to address unmet medical needs. The Company devotes extensive efforts to increase access to medicines through far-reaching programs that not only donate its medicines but help deliver them to the people who need them. Merck also publishes unbiased health information as a not-for-profit service.
Serena Thomson, +44-(0)7787-537370, for Merck & Co., Inc. NOTE TO EDITORS: For further information regarding the survey results, please refer to the accompanying fact sheet titled "EU Cardiology Survey."