• V Giner Galvañ, I Bonig Trigueros, L Fácila Rubio, P Morillas Blasco, S Martínez Hervás, V Pascual Fuster, F Valls Roca, C Soler Portmann, J J Tamarit García, V Pallarés Carratalá, en representación del Grupo de Trabajo MEJORA-LO CV, and Componentes del grupo de Trabajo MEJORALO-CV.
• Unidad de HTA y Riesgo Cardiometabólico, Servicio de Medicina Interna, Hospital Clínico Universitario de San Juan, San Juan de Alicante, Alicante, España; Departamento de Medicina Clínica, Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, España. Electronic address: giner_vicgal@gva.es.
• Rev Clin Esp. 2020 Jun 1; 220 (5): 282-289.

ObjectiveTo determine the management of dyslipidaemia in primary care after the publication of the American College of Cardiology/American Heart Association (ACC/AHA) 2013 guidelines and Valencian government's algorithm.MethodWe conducted a cross-sectional descriptive study that employed a survey of primary care physicians of the Community of Valencia between January and October 2016.ResultsA total of 199 physicians (mean age, 48.9±11.0 years; experience, 21.3±11.1 years) participated in the survey. The most followed guidelines were those of the European Society of Cardiology (37.5% of respondents) and Valencian government (23.4% of respondents). Some 6.3% of the respondents followed the 2013 ACC/AHA guidelines, and 88.0% established objectives based on LDL cholesterol and cardiovascular risk. The choice of lipid-lowering drug was based on its LDL cholesterol lowering capacity (28.6% of respondents), on the Valencian government's algorithm (23.4%) and on the drug's safety (20.4%). Statins, ezetimibe and fibrates were the preferred hypolipemiant agents, and their combination (51% of respondents) and dosage increases (35%) were the strategies employed for poor control. Lipid profile and transaminase and creatine kinase levels were measured every 6 (59.5%, 52.3% and 54.3% of respondents, respectively) or 12 months (25.1%, 29.2% and 30.3%, respectively). Forty-one percent of the respondents were aware of the controversy surrounding the 2013 ACC/AHA guidelines. Although 60% of the respondents acknowledged its relevance, only 21% changed their daily practices accordingly.ConclusionsThe Valencian government's algorithm had a greater impact than the 2013 ACC/AHA guidelines in primary care in Valencia. Areas for improvement included the low use of validated guidelines and risk tables and the streamlining of laboratory test periodicity.Copyright © 2019 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

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