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The Pharmaceutical Journal
Vol 270 No 7232 p73
18 January 2003

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Archives of Internal Medicine abstract (more)
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More education will improve treatment of high cholesterol

More education of patients and health care providers is needed to improve the treatment of people with familial hypercholesterolaemia and their compliance with medication, the authors of a new study say.

The Dutch study of 747 patients assessed treatment and compliance following diagnosis of familial hypercholesterolaemia through a genetic screening programme. At screening, 38 per cent of patients were already receiving cholesterol-lowering medication, but undertreatment was identified in these patients.

At a two-year follow up, the number of patients being treated rose to 86 per cent. As expected, patients not previously treated experienced decreases in total cholesterol, triglycerides and low-density lipoprotein (LDL) cholesterol, and increases in high-density lipoprotein cholesterol.

Though important decreases in cardiovascular risk were likely as a result of the changes, the authors note that a third of patients were still not achieving target levels for LDL cholesterol after two years. In addition, 103 patients at follow-up (14 per cent) had either discontinued or never started medication. For 51 patients, this was on the advice of their physician. For others it was due to general disinterest.

For this group of patients and their physicians, additional education is required, the authors say (Archives of Internal Medicine 2003;163:65).

Aspirin in hyperlipidaemia Patients with high levels of total and low-density lipoprotein (LDL) cholesterol may be poor responders to the antiplatelet effects of aspirin, a study suggests.

Nine out of 13 patients identified as hyperlipidaemic had poor responsiveness to aspirin. Most of the poor responders were taking lipid-lowering medicines. Poor responders may need to take higher doses of aspirin (more than 325mg/day), alternative antiplatelet agents or further reductions in concentrations of total cholesterol and LDL cholesterol, the authors say (BMJ 2003;326:82).