The low-density lipoprotein cholesterol-lowering effect of pravastatin andfactors associated with achieving targeted low-density lipoprotein levels in an African-American population

Study Objectives. To describe the low-density lipoprotein cholesterol (LDL) -lowering effect of pravastatin in African-American patients and to identif y factors associated with achieving National Cholesterol Education Program (NCEP)-defined target levels. Design. Retrospectively defined cohort study. Setting. Large, government-owned, teaching hospital. Patients. Eighty-four African-American patients starting therapy with prava statin in October-November 1997. Interventions. None. Measurements and Main Results. Whether or not target LDL concentrations wer e achieved was used to measure efficacy. Stepwise logistic regression ident ified the target LDL, baseline LDL, and baseline high-density lipoprotein c holesterol (HDL) as significant predictors of achieving the target. The pro portion of patients achieving their target LDL when that target was below 1 60, below 130, and 100 mg/dl or below was 64%, 32%, and 13% (p=0.004), resp ectively. Medical record review identified the reasons for not achieving ta rget as incorrect drug regimen, inadequate lipid monitoring, and noncomplia nce. Conclusion. These results indicate that substantial numbers of patients rec eiving lipid-lowering therapy are not meeting NCEP-defined targets and that with increased drug monitoring and compliance, improvements in achieving N CEP target LDL levels could be realized.