The decreased achievement of therapeutic goal in lipid lowering therapy in obese and diabetic patients in Poland.

BACKGROUND: Statins are used to reduce a cardiovascular risk. However, the effectiveness of the therapy in many cases remains unsatisfactory. Therefore, the aim of this study was to evaluate the influence of obesity and diabetes on the achievement of therapeutic goal in lipid-lowering therapy in patients with a various cardiovascular risk in the daily clinical practice. METHODS: This study was conducted on the basis of questionnaires obtained from 7018 patients (41.4% obese, 65.9% viscerally obese and 25.3% diabetics) treated with statins for at least three months. The effectiveness of the treatment was assessed in a subgroup of 3218 patients with a full lipid profile. RESULTS: The LDL-cholesterol target, adjusted for cardiovascular risk, was obtained by 8.1% of patients, less frequently by those with a very high risk of a cardiovascular disease (3.7%), obesity (5.5%), visceral obesity (5.5%) and the type 2 diabetes (5.3%). The obese patients with type 2 diabetes were the least likely to reach the target (3.0%). Male gender, age, the body mass index (BMI)≥28kg/m2, visceral obesity, type 2 diabetes, and a low/moderate statin dose prescription were independent factors decreasing the chance of reaching the low-density lipoprotein (LDL) cholesterol target. CONCLUSIONS: 1. The prescribed statin doses do not fully explain the lower frequency of achieving the recommended target in a lipid-lowering therapy in the obese patients and the diabetics. 2. In the daily clinical practice the doses of statins are frequently insufficient and not adjusted for a cardiovascular risk.