ArticleBMJ (Clinical research ed.)2003
Cross sectional survey of effectiveness of lipid lowering drugs in reducing serum cholesterol concentration in patients in 17 general practices.
Article in BMJ (Clinical research ed.), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Meta-analysis of large randomized controlled trials to evaluate the impact of statins on cardiovascular outcomes.British journal of clinical pharmacology · 2004Pooled it
- National Drug Formulary review of statin therapeutic group using the multiattribute scoring tool.Therapeutics and clinical risk management · 2013Article
- Effect of statins on the mortality of patients with ischaemic heart disease: population based cohort study with nested case-control analysis.Heart (British Cardiac Society) · 2006Article
- Statin use in the secondary prevention of coronary heart disease in primary care: cohort study and comparison of inclusion and outcome with patients in randomised trials.BMJ (Clinical research ed.) · 2005Article
- Ineffectiveness of lipid-lowering therapy in primary care.British journal of clinical pharmacology · 2005Article
- Whom are we treating with lipid-lowering drugs? Are we following the guidelines? Evidence from a population-based study: the Tromso study 2001.European journal of clinical pharmacology · 2004Article
- Recent trends in (under)treatment of hypercholesterolaemia in the Netherlands.British journal of clinical pharmacology · 2004Article
- Effectiveness of lipid lowering drugs in general practice: article illustrates major problem.BMJ (Clinical research ed.) · 2003Article
- Effectiveness of lipid lowering drugs in general practice: study had two major flaws.BMJ (Clinical research ed.) · 2003Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the effectiveness of lipid lowering drugs in lowering serum cholesterol concentrations.
designCross sectional study.
setting17 practices within 17 primary care groups in Trent region, United Kingdom.
participantsPatients aged 35 years or over taking lipid lowering drugs and with at least two serum cholesterol concentrations recorded on computer.
main outcome measuresProportion of patients achieving serum cholesterol concentration of < or =5 mmol/l and mean percentage reduction in serum cholesterol concentration.
results1353 of 2469 (54.8%) patients receiving lipid lowering treatment had a last recorded serum cholesterol concentration of < or =5 mmol/l. Significantly more patients taking statins achieved the target value for serum cholesterol (5 mmol/l) than those taking fibrates (1307 (57%) v 46 (26%); P<0.0001). Atorvastatin and simvastatin were the most effective drugs in achieving the target. Significant differences were found between lipid lowering drugs for the pretreatment serum cholesterol concentration, the most recent cholesterol concentration, and the associated percentage reduction. Atorvastatin and simvastatin achieved the greatest percentage reduction in serum cholesterol concentrations (30.1%, 95% confidence interval 28.8% to 31.4%, and 28.0%, 26.7% to 29.3%, respectively). Although the mean serum cholesterol concentrations in this unselected population tended to be higher than those in clinical trials, the percentage reduction was consistent with the trials.
conclusionThe ability of individual statins to lower serum cholesterol concentration varied, with atorvastatin and simvastatin being the most effective. The percentage reductions agreed with those of randomised controlled trials indicating likely benefits in unselected patients in primary care. As the initial serum cholesterol concentrations were higher than those in randomised controlled trials, target serum cholesterol values of < or =5 mmol/l may be unrealistic even for patients taking the most efficacious drugs. Also, the higher initial levels could mean that the absolute reduction in cardiovascular risk in primary care patients is greater than thought.
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