• Nathan D Wong, Joanna Chuang, Yanglu Zhao, and Paul D Rosenblit.
• Division of Cardiology, Heart Disease Prevention Program, University of California, Irvine, CA, USA. Electronic address: ndwong@uci.edu.
• J Clin Lipidol. 2015 Jul 1; 9 (4): 525-32.

BackgroundDespite being on treatment, many persons with dyslipidemia still have suboptimal lipid levels and still experience cardiovascular disease (CVD) events.ObjectiveWe examined the extent of residual dyslipidemia in terms of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB), in the US population, despite treatment with statin therapy.MethodsWe evaluated the attainment of LDL-C, non-HDL-C, and apoB targets in statin-treated subjects in the National Health and Nutrition Examination Survey 2009-2010. We report on percentage of individuals who attained goal and the mean distance from goal. LDL-C goals were set at <70 mg/dL for those with coronary heart disease, <100 mg/dL for those with other CVDs, diabetes, chronic kidney disease or >20% 10-year CVD risk, <130 mg/dL for those with 10% to 20% 10-year CVD risk or 2+ risk factors, and <160 mg/dL in those with <10% 10-year CVD risk or no more than 1 risk factor. Goals for non-HDL-C were 30 mg/dL higher than corresponding LDL-C goals, and goals of apoB were set to correspond with the same percentile of each LDL-C goal.ResultsOf the 5995 US adults aged ≥ 18 years surveyed, 463 (7.7%) were identified as being on a statin-based therapy. Overall, 64% of statin users were at goal for LDL-C, 63% were at goal for non-HDL-C, but only 52% were at goal for apoB. Of those who did not reach goal, 41%, 29%, and 39% were 30% or more from goal for LDL-C, non-HDL-C, and apoB, respectively. Non-Hispanic blacks and those with CVD or diabetes had the highest proportions that were not at goal for LDL-C, non-HDL-C, and apoB. Among those at goal for non-HDL-C, 50% of those with CHD and 33% of other high risk adults were not at ApoB goals.ConclusionsDespite statin treatment, many persons continue to have residual dyslipidemia with LDL-C, non-HDL-C, and/or apoB levels not being at recommended levels.Copyright © 2015 National Lipid Association. Published by Elsevier Inc. All rights reserved.

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