Abstract 5142: Low-density Lipoprotein Cholesterol Goal Attainment in Dyslipidemic Women and Men: Analysis of the Lipid Treatment Assessment Project (L-TAP) 2
Background: Information on LDL-C goal attainment is particularly important for optimizing lipid management in women, who have often been under-represented in major cardiovascular (CV) trials. This analysis evaluates whether LDL-C success rates according to National Cholesterol Education Program Adult Treatment Panel (NCEP ATP) III guidelines differed by gender in the L-TAP 2 population.
Methods: Patients aged ≥20 years with dyslipidemia on stable lipid lowering therapy were assessed at investigation sites in 9 countries between September 2006 and April 2007. Lipid levels were determined once in each patient at the time of enrollment. Clinical characteristics were compared between genders using logistic regression for categorical variables and ANOVA for continuous variables. LDL-C goal attainment by risk level and region was compared between genders using logistic regression.
Results: A total of 9,955 patients (45% women) were evaluated in the US, Canada, Brazil, Mexico, France, the Netherlands, Spain, Korea, and Taiwan. Women compared with men had higher mean age (63±12 vs 61±12 years, p<0.0001), LDL-C (105 vs 96 mg/dL, p<0.0001), and HDL-C (58 vs 48 mg/dL, p<0.0001). Women were less likely than men to be current smokers (10% vs 17%, p<0.0001) and to receive statin therapy (79% vs 81%, p=0.0004). Women had a significantly lower overall LDL-C success rate than men (71% vs 74%; p=0.014). LDL-C success rates did not differ significantly by gender in low and moderate risk groups. Women in the high risk group were less likely than men to achieve the target LDL-C of <100 mg/dL (63% vs 71%, p<0.0001) and among CHD patients, less likely to achieve an LDL-C <70 mg/dL (26% vs 31%, p=0.0033). Women had a significantly lower LDL-C success rate than men in North America (73% vs 79%, p<0.0001) but not in Europe or Asia. Multivariate predictors of successful LDL-C goal achievement in both women and men were type of lipid-lowering therapy, diabetes, and a family history of CHD. Hypertension was a predictor in women only, and older age and smoking status were predictors in men only.
Conclusions: This analysis indicates that high risk women are under-treated compared to men and that there is a substantial opportunity to improve lipid management and reduce CV risk in this population.