Compliance with lipid-lowering therapy and its impact on cardiovascular morbidity and mortality.

BACKGROUND

Hypercholesterolemia is a major risk factor for cardiovascular disease.

OBJECTIVE

Treatment with hypolipidemic agents reduces the risk of vascular events both in primary and secondary prevention. Although compliance with lipid-lowering therapy is an important determinant of cardiovascular clinical outcomes, relatively little attention is being paid to this issue by physicians.

METHODS

We searched the literature using Pubmed up to 5 August 2008.

RESULTS

Compliance with lipid-lowering therapy is poor in clinical practice, especially in primary prevention. As many as 6 out of 10 patients may stop taking statins during the first 6 months following initiation of treatment. Poor compliance has been associated with worse clinical outcome and increased cardiovascular morbidity and mortality. Importantly, statin withdrawal may be even worse compared with not taking statins at all. Several strategies may increase treatment adherence.

CONCLUSIONS

Poor compliance with lipid-lowering treatment is an important health issue that has been associated with unfavorable cardiovascular outcome. Increasing adherence rates should become a major concern for physicians.