Residual dyslipidemia according to low-density Lipoprotein cholesterol, non high-density lipoprotein cholesterol, and apolipoprotein B among statin-treated US adults: National Health and Nutrition Examination Survey 2009-2010

BACKGROUND: Despite being on treatment, many persons with dyslipidemia still have suboptimal lipid levels and still experience cardiovascular disease (CVD) events. OBJECTIVE: We 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. METHODS: We 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 BDL-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. RESULTS: Of 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. CONCLUSIONS: Despite statin treatment, many persons continue to have residual dyslipidemia with LDL-C, non HDL-C, and/or apoB levels not being at recommended levels. (C) 2015 National Lipid Association. All rights reserved.