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Results of the National Cholesterol Education (NCEP) Program Evaluation Project Utilizing Novel E-Technology (NEPTUNE) II Survey and Implications for Treatment Under the Recent NCEP Writing Group Recommendations
Abstract
The most recent national survey of compliance with the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) guidelines was completed before ATP III and showed significant underachievement of low-density lipoprotein (LDL) cholesterol goals. The NCEP Evaluation ProjecT Utilizing Novel E-Technology (NEPTUNE) II was a national survey conducted in 2003. Of the 4,885 patients, 67% achieved their LDL cholesterol treatment goal, including 89%, 76%, and 57%, respectively, in the 0 or 1 risk factor, > or = 2 risk factors or coronary heart disease (CHD), and CHD risk equivalent categories. The percentage with triglyceride concentrations > or = 200 mg/dl (2.25 mmol/L) in each risk category who achieved their LDL cholesterol and non-high-density lipoprotein cholesterol goals was 64%, 52%, and 27%, respectively. Patients with diabetes (55%) and other CHD risk equivalents (40%) were less likely to have achieved their LDL cholesterol targets than those with CHD (62%). Of the 1,447 patients with cardiovascular disease, 75% could be classified as very high risk according to the new July 2004 NCEP Writing Group recommendations, and 17.8% of those at very high risk had an LDL cholesterol level of <70 mg/dl (<1.81 mmol/L). In conclusion, these results suggest improved lipid management compared with previous surveys. The largest treatment gaps were found for features new to ATP III as of July 2004, including goal achievement for patients with CHD risk equivalents and for non-high-density lipoprotein cholesterol targets. Most of those (75%) with cardiovascular disease in NEPTUNE II would be considered very high risk and candidates for aggressive therapy to reach the new optional treatment goals.
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“For example, in the National Cholesterol Education Program Evaluation Project Utilizing Novel E-Technology (NEPTUNE) II survey, the proportion of individuals with triglyceride levels Ն200 mg/dL who had achieved their non-HDL-C goal ranged from 64% with 0 to 1 risk factor to 52% with Ն2 risk factors and only 27% with CVD risk equivalents.223”
From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [223]
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Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Self-citationExpert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011
Grundy, S. M., Cleeman, J. I., Merz, C. N. B., Brewer, H. B., Clark, L. T., Hunninghake, D. B., Pasternak, R. C., Smith, S. C., & Stone, N. J. (2004) · Circulation · doi:10.1161/01.cir.0000133317.49796.0e · Cited by 6,902
Self-citationThe Lipid Treatment Assessment Project (L-TAP)
Pearson, T. A., Laurora, I., Chu, H., & Kafonek, S. D. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.4.459 · Cited by 1,012
Self-citationFord, E. S., Mokdad, A. H., Giles, W. H., & Mensah, G. A. (2003) · Circulation · doi:10.1161/01.cir.0000066320.27195.b4 · Cited by 355
Intensive Statin Therapy — A Sea Change in Cardiovascular Prevention
Topol, E. J. (2004) · New England Journal of Medicine · doi:10.1056/nejme048061 · Cited by 196
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Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association
Miller, M., Stone, N. J., Ballantyne, C., Bittner, V., Criqui, M. H., Ginsberg, H. N., Goldberg, A. C., Howard, W. J., Jacobson, M. S., Kris-Etherton, P. M., et al. (2011) · Circulation · doi:10.1161/cir.0b013e3182160726 · Cited by 1,871
Self-citationHyperlipidemia as a Risk Factor for Cardiovascular Disease
Nelson, R. H. (2012) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2012.11.003 · Cited by 1,142
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Raal, F. J., Kallend, D., Ray, K. K., Turner, T., Koenig, W., Wright, R. S., Wijngaard, P. L. J., Curcio, D., Jaros, M. J., Leiter, L. A., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmoa1913805 · Cited by 818
Very Low Levels of Atherogenic Lipoproteins and the Risk for Cardiovascular Events
Boekholdt, S. M., Hovingh, G. K., Mora, S., Arsenault, B. J., Amarenco, P., Pedersen, T. R., LaRosa, J. C., Waters, D. D., DeMicco, D. A., Simes, R. J., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.02.615 · Cited by 581
Metadata
- Authors
- Davidson, M. H., Maki, K. C., Pearson, T. A., Pasternak, R. C., Deedwania, P. C., McKenney, J. M., Fonarow, G. C., Maron, D. J., Ansell, B. J., Clark, L. T., & Ballantyne, C. M.
- Affiliations
- University of Rochester Medicine (US)
- Massachusetts General Hospital (US)
- National Clinical Research (US)
- University of California, Los Angeles (US)
- Vanderbilt University (US)
- SUNY Downstate Health Sciences University (US)
- Baylor College of Medicine (US)
- Corresponding author
- Davidson, Michael H.
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2005-08
- Volume
- 96
- Issue
- 4
- Pages
- 556-563
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W1969054950
- Cited by
- 270
- References
- 6
- Citations by year
- 2026: 1 · 2024: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 4 · 2015: 12 · 2014: 15 · 2013: 16 · 2012: 19
- FWCI
- 28.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- National Cholesterol Education Program, Adult Treatment Panel III, non-HDL cholesterol, cardiovascular risk stratification, very high-risk patients, coronary artery disease, diabetes mellitus, treatment gap, lipid control, aggressive lipid-lowering therapy
- MeSH terms
- Anticholesteremic Agents, Cholesterol, Coronary Artery Disease, Female, Follow-Up Studies, Health Surveys, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Medical Laboratory Science, Hypertriglyceridemia, Program Evaluation, Treatment Outcome, Practice Guidelines as Topic
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