High prevalence and undertreatment of hypercholesterolaemia in participants in a public stroke prevention programme in Austria

Background: There is remarkable consistency in large cohort studies regarding the relationship between serum cholesterol and the incidence of coronary heart disease (CHD), and increasing interest in the relationship between serum cholesterol and stroke. The aim of our investigation was to identify the prevalence and control of hypercholesterolaemia in participants in a public stroke prevention programme. Patients and methods: 9274 participants were categorised according to the guidelines of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) and analysed with reference to risk category, treatment eligibility and treatment quality. Results: NCEP-ATP III identifies low-density lipoprotein (LDL) cholesterol as the primary target of treatment. In this programme, 499 (5.4%) subjects were classified as having optimal (<100 mg/dL) LDL cholesterol levels, 1718 (18.5%) as near optimal (100-129 mg/dL), 2863 (30.9%) as borderline high (130-159 mg/dL), 2472 (26.7%) as high (160-189 mg/dL) and 1722 (18.6%) as very high (>190 mg/dL). 4442 (47.9%) participants presented with 0-1 risk factors, 2451(26.4%) with multiple (2+) risk factors, and 2381 (25.7%) met the criteria of secondary prevention. The suggested treatment goals were met in 2411 (54.3%) participants with 0-1 risk factors, in 561 (22.9%) of the multiple-risk-factor group, and in 148 (6.2%) subjects with established CHD or risk equivalents. A total of 871 subjects (9.4%) reported use of cholesterol-lowering drugs. Conclusions: We observed a considerable prevalence and poor control of hypercholesterolaemia in participants in a public stroke prevention programme in Austria.