Low adherence of General Practitioners to National Cholesterol Education Program guidelines for the management of hyperlipidaemia

Aim of our study was to assess adherence to the National Cholesterol Educat ion Program Adult-Treatment Panel II (NCEP-ATP II) in patients cared for by General Practitioners (GPs) in an Italian community, The design of the wor k was cross-sectional cohort study; the base was an unselected cohort of 11 68 patients cared for by GPs and screened at our lipid clinic in 1994-1995 in the Province of Turin (Italy), Blood samples were collected after 12-hr fast to measure plasma levels of total cholesterol, triglycerides, HDL-chol esterol, glucose and thyroid-stimulating hormone (TSH). LDL-cholesterol was calculated using Friedewald's formula, In patients with body mass index (B MI) >30 kg/m(2), an oral glucose tolerance test was performed, Blood pressu re was measured in all patients, and a baseline ECG or a stress test was pe rformed in those with unknown cardiovascular disease (CVD), then they were classified following the NCEP-ATP II criteria. Primary hyperlipidaemia acco unted for 86.9% of the cohort with most patients requiring pharmacological treatment; in 34.4% of the patients, LDL-cholesterol values were greater th an or equal to 6.46 mmol/l (250 mg/dl) and in 23.7% with established CVD, L DL-cholesterol levels were greater than or equal to 5.68 mmol/l (220 mg/dl) , In only 7.3% of patients the NCEP treatment goals were achieved, with 1.3 % among those in secondary prevention, We observed great discrepancies betw een clinical practice and international recommendations for the management of hyperlipidaemia. Diab. Nutr. Metab. 13: 263-268, 2000. (C) 2000, Editric e Kurtis.