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. 2015 May;12(3):239-45.
doi: 10.11909/j.issn.1671-5411.2015.03.004.

Attainment of multifactorial treatment targets among the elderly in a lipid clinic

Fotios Barkas  1 , Evangelos Liberopoulos  1 , Eleftherios Klouras  1 , Angelos Liontos  1 , Moses Elisaf  1
Affiliations

Attainment of multifactorial treatment targets among the elderly in a lipid clinic

Fotios Barkas et al. J Geriatr Cardiol. 2015 May.

Abstract

Objective: To examine target attainment of lipid-lowering, antihypertensive and antidiabetic treatment in the elderly in a specialist setting of a University Hospital in Greece.

Methods: This was a retrospective study including consecutive subjects ≥ 65 years old (n = 465) with a follow-up ≥ 3 years. Low-density lipoprotein cholesterol (LDL-C), blood pressure (BP) and glycated hemoglobin (HbA1c) goal achievement were recorded according to European Society of Cardiology/European Atherosclerosis Society (ESC/EAS), European Society of Hypertension (ESH)/ESC and European Association for the Study of Diabetes (EASD) guidelines.

Results: The LDL-C targets were attained by 27%, 48% and 62% of very high, high and moderate risk patients, respectively. Those receiving statin + ezetimibe achieved higher rates of LDL-C goal achievement compared with those receiving statin monotherapy (48% vs. 33%, P < 0.05). Of the diabetic subjects, 71% had BP < 140/85 mmHg, while 78% of those without diabetes had BP < 140/90 mmHg. A higher proportion of the non-diabetic individuals (86%) had BP < 150/90 mmHg. Also, a higher proportion of those with diabetes had HbA1c < 8% rather than < 7% (88% and 47%, respectively). Of note, almost one out of three non-diabetic individuals and one out of ten diabetic individuals had achieved all three treatment targets.

Conclusions: Even in a specialist setting of a University Hospital, a high proportion of the elderly remain at suboptimal LDL-C, BP and HbA1c levels. The use of drug combinations could improve multifactorial treatment target attainment, while less strict targets could be more easily achieved in this population.

Keywords: Blood pressure; Glycated hemoglobin; Goal achievement; Low-density lipoprotein cholesterol.

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