Adherence to Preferable Behavior for Lipid Control by High-Risk Dyslipidemic Japanese Patients Under Pravastatin Treatment: the APPROACH-J Study

作者：Kitagawa Yasuhisa^*; Teramoto Tamio; Daida Hiroyuki

来源：Journal of Atherosclerosis and Thrombosis, 2012, 19(9): 795-805.

DOI：10.5551/jat.12682

• Dyslipidemia
• Pravastatin
• Adherence
• LDL cholesterol

Aim: We evaluated the impact of adherence to preferable behavior on serum lipid control assessed by a self-reported questionnaire in high-risk patients taking pravastatin for primary prevention of coronary artery disease. %26lt;br%26gt;Methods: High-risk patients taking pravastatin were followed for 2 years. Questionnaire surveys comprising 21 questions, including 18 questions concerning awareness of health, and current status of diet, exercise, and drug therapy, were conducted at baseline and after 1 year. Potential domains were established by factor analysis from the results of questionnaires, and adherence scores were calculated in each domain. The relationship between adherence scores and lipid values during the 1-year treatment period was analyzed by each domain using multiple regression analysis. %26lt;br%26gt;Results: A total of 5,792 patients taking pravastatin were included in the analysis. Multiple regression analysis showed a significant correlation in terms of %26quot;Intake of high fat/cholesterol/sugar foods%26quot; (regression coefficient -0.58, p = 0.0105) and %26quot;Adherence to instructions for drug therapy%26quot; (regression coefficient -6.61, p %26lt; 0.0001). Low-density lipoprotein cholesterol (LDL-C) values were significantly lower in patients who had an increase in the adherence score in the %26quot;Awareness of health%26quot; domain compared with those with a decreased score. There was a significant correlation between high-density lipoprotein (HDL-C) values and %26quot;Awareness of health%26quot; (regression coefficient 0.26; p = 0.0037), %26quot;Preferable dietary behaviors%26quot; (regression coefficient 0.75; p %26lt; 0.0001), and %26quot;Exercise%26quot; (regression coefficient 0.73; p = 0.0002). Similar relations were seen with triglycerides. %26lt;br%26gt;Conclusion: In patients who have a high awareness of their health, a positive attitude toward lipid-lowering treatment including diet, exercise, and high adherence to drug therapy, is related with favorable overall lipid control even in patients under treatment with pravastatin.

• 出版日期2012