Factors associated with compliance to lipid-lowering treatment in China

Posted On 2013-04-19 10:14:59
Because of rapid changes in lifestyle and risk factors, cardiovascular disease has become the leading cause of death in China. A cross-sectional study in a nationally representative sample of 46 239 adults aged ≥20 years,published in 2012, demonstrated that serum total and low-density lipoprotein cholesterol levels were high and increasing in the Chinese population. (1) The authors predicted that without effective intervention, atherosclerotic cardiovascular diseases may soar in the near future.

In the April issue of the European Journal of Preventive Cardiology, a group of investigators from the Peking University Clinical Research Instituteexplore factors that influence compliance with treatment of dyslipidaemia, using a multi-centre sample from China. (2)

Through review of medical notes and direct interviews at two points in time (2006 and 2007) of 2094 patients in 27 hospitals receivinglipid-lowering therapy since 2004, 1890 patients were recruited who had been on treatment for more than one year. Good compliance (GC) was defined as days taking lipid-lowering drugs/total days of follow-up ≥ 80%. Logistic regression models were used to assess factors associated with GC.

In patients with one, two and three years of treatment respectively, GC was greater in those with higher versus lower medical insurance cover - odds ratios 2.8 (95%CI 2.2-3.7), 2.0 (1.5-2.7), 4.3 (2.3-8.1); in patients in province-level versus county-level hospitals-2.0 (1.5-2.6), 2.9 (2.0-4.1), 4.6 (1.8-12.0); in patients treated by non-cardiology physicians compared to cardiologists -1.7 (1.1-2.5), 2.0 (1.3-3.0), 4.0 (1.5-10.3) and in patients using a statin versus other forms of medication for dyslipidaemia -1.7 (1.2-2.2), 1.7 (1.2-2.3), 4.4 (2.3-8.5).

The authors conclude that better medical insurance cover, care in a province-level hospital rather than county-level hospital, treatment by a non-cardiologist and use of a statin were associated with better compliance to lipid-lowering treatment. With an estimated 200 million people with dyslipidaemia in China, these results are important for future risk management.

1.Yang W, Xiao J, Yang Z, Ji L, Jia W, Weng J, Lu J, Shan Z, Liu J, Tian H, Ji Q, Zhu D, Ge J, Lin L, Chen L, Guo X, Zhao Z, Li Q,Zhou Z, Shan G, He J; China National Diabetes and Metabolic Disorders Study Investigators.Serum lipids and lipoproteins in Chinese men and women.Circulation. 2012;125:2212-21. 

2. Xie G, Zaman MJ, Myint PK, Liang L, Zhao L, Wu Y. Factors associated with compliance to lipid-lowering treatment in China.Eur J PrevCardiol. 2013 Apr;20(2):229-37.

See also: Article snapshot: Growth, Urbanization and Health in China