How has the treatment of hypercholesterolemia in Poland changed over the last six years?

Background: To assess changes in the treatment of hypercholesterolemia in Polish ambulatory care over the last 6 years. Methods: Data were obtained from two separate questionnaire-based studies, conducted in 2009 and 2015. The analysis included only those patient visits, which were associated with modifications of previous hypercholesterolemia treatment (1924 visits from the year 2009 and 1888 visits from the year 2015). Results: In the present registry, there was a 19 mg/dL reduction in the level of total cholesterol and a 17 mg/dL reduction in the level of low-density lipoprotein compared to year 2009. In both registries, the most common reason for treatment modification was failure to achieve therapeutic goals. Compared to year 2009, there was an increase in the proportion of patients treated with atorvastatin and a reduction in the proportion of patients treated with simvastatin at baseline; additionally, in year 2015, 10% of patients received rosuvastatin. After therapy modification, there was a similar increase in the proportion of patients treated with a statin-fibrate combination in both registries. However, at present, ezetimibe was significantly less often added to previous therapy. In both registries, therapy modification led to an increase in the mean doses of the most commonly used statins, although presently, this increase was smaller than in 2009. Conclusions: The most favorable change in the treatment of hypercholesterolemia is an increase in the proportion of patients treated with strong statins. Unfavorable changes include a reduction in the frequency of polytherapy, especially with ezetimibe, and a tendency to prescribe lower, ineffective statin doses.