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  2. Keyword: Hypolipidemic Agents
Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy
ABC
Original Article

Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy

Andressa Braga et al. Marisa Santos Carlos Magliano Katia Senna … Bernardo Tura Ione Oliveira

ABSTRACT

Background:

The 2017 Brazilian Guideline on Dyslipidemias recommends a low-density lipoprotein (LDL-c) target of <50 mg/dL for patients under secondary prevention of cardiovascular events, with statin therapy and the addition of ezetimibe if necessary. For patients who do not achieve this target, additional pharmacotherapy is indicated.

Objectives:

This study combined population data from the Brazilian Unified Health System (SUS) and the supplementary health system, epidemiological data, and the Delphi method, with participation from 29 specialists in the first round and 24 in the second, to estimate the size of the secondary prevention population not achieving LDL-c targets.

Results:

The population under secondary prevention was estimated at 5,8 million in the public health system and 1,2 million in the supplementary health system. Approximately one million patients in SUS and 150 thousand in the supplementary system are not expected to reach the LDL-c target with oral lipid-lowering therapy.

Conclusion:

Between 9% and 19% of patients under secondary prevention do not reach the recommended LDL-c target, making them potential candidates for additional LDL-c–lowering therapies.

  • Cardiovascular Diseases
  • Hypolipidemic Agents
  • Population Forecast
  • Secondary Prevention
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Creative Commons Attribution (CC BY) Creative Commons license
18/08/2025 DOI: 10.36660/abc.20240617i
Figure 1
ABC
Research Letter

Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia

Enrico Manfredini et al. Renato Jorge Alves

Introduction

Hyperlipidemia can increase morbidity and mortality. This condition has been classified by Fredrickson into the following phenotypes: I, IIa, IIb, III, IV and V.– In the mixed ones, the following conditions are present: hypercholesterolemia and hypertriglyceridemia, phenotypes IIb and III, with cholesterolemia and triglyceridemia of 250 to 300 mg/dL in phenotype IIb, and 500 to 600 mg/dL or more, in III, respectively. Pancreatitis is uncommon in both, as well as xanthomatosis in IIb. Xanthomas and cardiovascular complications are more frequent in phenotype III.,

We present a case of hyperlipidemia with relevant lipid abnormalities, pancreatitis and exuberant xanthomatosis.

[…]

  • Dyslipidemias
  • Hyperlipidemias
  • Hypolipidemic Agents
  • Xanthomatosis
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Creative Commons Attribution (CC BY) Creative Commons license
06/09/2021 DOI: 10.36660/abc.20200999
ABC
Viewpoint

Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study

Luis C. L. Correia

Ezetimibe: Clinical and scientific meaning of the IMPROVE-IT study

After years of anxious wait, in June of the current year, the results of the clinical trial IMPROVE-IT were published in the New England Journal of Medicine. This was the first study to properly evaluate the clinical impact of adding ezetimibe to statin therapy. Until then, we had known that the combination of ezetimibe with statin enhanced the antihyperlipidemic effect of statins (surrogate endpoint). However, a positive surrogate marker does not necessarily have a guaranteed clinical impact on the therapy. Therefore, the IMPROVE-IT would fill a gap in the literature concerning the effect of ezetimibe on clinical outcomes.

The publication of the ENHANCE study in 2008 created uncertainty about the efficacy of the therapy with ezetimibe. In this randomized, clinical trial including patients with familial hypercholesterolemia, the therapy with ezetimibe added to 80 mg of simvastatin led to greater reductions in LDL cholesterol levels as compared with simvastatin alone. However, the effect was not accompanied by a greater reduction in atherosclerosis, measured by the carotid intima-media thickness (surrogate endpoint). At this point, it became evident that the industry was precipitate in promoting the use of a drug before its effects were demonstrated by clinical outcomes.

[…]

  • Cholesterol
  • Drug Combination
  • Ezetimibe
  • Hydroxymethylglutaryl CoA- Redutases
  • Hypolipidemic Agents
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Creative Commons Attribution (CC BY) Creative Commons license
01/03/2016 DOI: 10.5935/abc.20160033 Views 2

How to cite this article

EndNote RIS

Electronic Document Format (Vancouver)

Braga A, Santos M, Magliano C, Senna K, Tura B, Oliveira I. Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy. Arquivos Brasileiros de Cardiologia 2025;122(7):e20240617.

Electronic Document Format (ABNT)

Braga, Andressa; Santos, Marisa; Magliano, Carlos; Senna, Katia; Tura, Bernardo; Oliveira, Ione. Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy. Arquivos Brasileiros de Cardiologia, v. 122, n. 7, e20240617, Aug. 2025.

Electronic Document Format (APA)

Braga, A., Santos, M., Magliano, C., Senna, K., Tura, B., & Oliveira, I. (2025). Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy. Arquivos Brasileiros de Cardiologia, 122(7), e20240617.

Electronic Document Format (ISO)

Braga, Andressa and Santos, Marisa and Magliano, Carlos and Senna, Katia and Tura, Bernardo and Oliveira, Ione. Estimate of Brazilians Under Secondary Prevention of Cardiovascular Events Who Do Not Achieve LDL Cholesterol Targets with Lipid-Lowering Therapy. Arquivos Brasileiros de Cardiologia [online]. 2025, vol. 122, n. 7, [cited 2026-10-14], e20240617. Available from: <https://journals.cardiol.br/en/article/estimate-of-brazilians-under-secondary-prevention-of-cardiovascular-events-who-do-not-achieve-ldl-cholesterol-targets-with-lipid-lowering-therapy/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Manfredini E, Alves RJ. Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia. Arquivos Brasileiros de Cardiologia 2021;117(2):407-10.

Electronic Document Format (ABNT)

Manfredini, Enrico; Alves, Renato Jorge. Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia. Arquivos Brasileiros de Cardiologia, v. 117, n. 2, p. 407-410, Sep. 2021.

Electronic Document Format (APA)

Manfredini, E., & Alves, R. J. (2021). Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia. Arquivos Brasileiros de Cardiologia, 117(2), 407-410.

Electronic Document Format (ISO)

Manfredini, Enrico and Alves, Renato Jorge. Unusual Finding of Rare Exuberant Xanthomatosis in Hyperlipidemia. Arquivos Brasileiros de Cardiologia [online]. 2021, vol. 117, n. 2, [cited 2026-10-14], pp. 407-410. Available from: <https://journals.cardiol.br/en/article/unusual-finding-of-rare-exuberant-xanthomatosis-in-hyperlipidemia/>. ISSN 0066-782X

EndNote RIS

Electronic Document Format (Vancouver)

Correia LCL. Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arquivos Brasileiros de Cardiologia 2016;106(3):247-9.

Electronic Document Format (ABNT)

Correia, Luis C. L.. Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arquivos Brasileiros de Cardiologia, v. 106, n. 3, p. 247-249, Feb. 2016.

Electronic Document Format (APA)

Correia, L. C. L. (2016). Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arquivos Brasileiros de Cardiologia, 106(3), 247-249.

Electronic Document Format (ISO)

Correia, Luis C. L.. Ezetimibe: Clinical and Scientific Meaning of the IMPROVE-IT Study. Arquivos Brasileiros de Cardiologia [online]. 2016, vol. 106, n. 3, [cited 2026-10-14], pp. 247-249. Available from: <https://journals.cardiol.br/en/article/ezetimibe-clinical-and-scientific-meaning-of-the-improve-it-study/>. ISSN 0066-782X

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