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Ethnic differences in achievement of cholesterol treatment goals

Results from the national cholesterol education program evaluation project utilizing novel E-technology II

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Abstract

BACKGROUND: African Americans (AA) have the highest coronary heart disease mortality rate of any ethnic group in the United States. Data from the National Cholesterol Education Program Evaluation ProjecT Utilizing Novel E-Technology (NEPTUNE) II survey were used to assess ethnic differences in low-density lipoprotein cholesterol (LDL-C) goal achievement.

METHODS: NEPTUNE II surveyed patients with treated dyslipidemia to assess achievement of treatment goals established by the Adult Treatment Panel III of the National Cholesterol Education Program. United States physicians working in primary care or relevant subspecialties enrolled 10 to 20 consecutive patients (May to September 2003), and patient data were recorded in Personal Digital Assistants and uploaded to a central database via the internet.

RESULTS: Among 4,885 patients receiving treatment for dyslipidemia, 79.7% were non-Hispanic white (NHW) and 8.4% were AA. Non-Hispanic white and AA patients had significantly different frequencies of treatment success, with 69.0% and 53.7%, respectively, having achieved their LDL-C goal (P<.001). African-American patients were more likely to be in the highest risk category, and less likely to be using lipid drug therapy, taking high-efficacy statins, and receiving care from a subspecialist, but the difference in goal achievement remained significant (P<.001) after adjustment for these and other predictors of treatment success.

CONCLUSIONS: The frequency of treatment success in dyslipidemia management was significantly lower in AA than NHW patients. Additional research is needed to elucidate reasons for this disparity and to evaluate strategies for improving goal achievement among AA patients receiving therapy for dyslipidemia.

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Authors and Affiliations

  1. State University of New York Downstate Medical Center, Brooklyn, NY, USA

    Luther T. Clark MD

  2. Vanderbilt University School of Medicine, Nashville, TN, USA

    David J. Maron MD

  3. University of Rochester School of Medicine, Rochester, NY, USA

    Thomas A. Pearson MD, MPH, PhD

  4. Radiant Development, 515 N. State St., Suite 2700, 60610, Chicago, IL

    Kevin C. Maki PhD, Ron Galant PhD &  Michael H. Davidson MD

Authors
  1. Luther T. Clark MD
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  2. Kevin C. Maki PhD
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  3. Ron Galant PhD
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  4. David J. Maron MD
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  5. Thomas A. Pearson MD, MPH, PhD
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  6. Michael H. Davidson MD
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Corresponding author

Correspondence to Michael H. Davidson MD.

Additional information

Dr. Clark has received honoraria for educational presentations and has received grant/research support from AstraZeneca Pharmaceuticals. Dr. Maki has received research grants from AstraZeneca Pharmaceuticals. Drs. Galant and Maron have no conflicts to report. Dr. Pearson has sat on an advisory board for AstraZeneca Pharmaceuticals. Dr. Davidson has received grant/research support, served as a consultant and on the speaker’s bureau, and received honoraria from AstraZeneca Pharmaceuticals.

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Clark, L.T., Maki, K.C., Galant, R. et al. Ethnic differences in achievement of cholesterol treatment goals. J Gen Intern Med 21, 320–326 (2006). https://doi.org/10.1111/j.1525-1497.2006.00349.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00349.x

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