HeartSafe Well Above National Average in Merck-Phizer Study for Managing Cardiovascular Risks

Study Background:

Studies indicate the importance of aggressively treating patients with elevated cholesterol who have coronary heart disease (secondary prevention), as well as those patients without coronary heart disease (primary prevention). The risk of having a fatal or non­fatal coronary event was reduced by up to 42% (24%-42%) in the secondary prevention studies and the risk of having a first coronary event was reduced by up to 36% (31%-36%) in the primary prevention studies. Recent studies and a National Cholesterol Education Panel (NCEP) report from July 2004 suggest an even more aggressive (E.G. LDL goals less than 70mg/dL) approach to managing lipids is warranted in those patients with coronary disease at highest risk for another coronary event. Based upon another recent study, this NCEP report also suggests that patients may benefit from the aggressive treatment of cholesterol in patients with high blood pressure, regardless of the baseline cholesterol level.

Additionally the most recent guidelines for the management of hypertension published in May 2003 describe the importance of aggressive blood pressure control, in particular the importance of systolic blood pressure, at reducing a patient's risk of developing cardiovascular disease endpoints such as stroke or myocardial infarction. Recently the largest hypertension (HTN) outcomes study was completed, which further demonstrated the importance of aggressive blood pressure control and reinforced that most patients with high blood pressure cannot be controlled on a single antihypertensive agent.

Despite these promising findings and recommendations, most patients with elevated cholesterol and blood pressure nationwide still do not meet their desired goals as *outlined by the National Cholesterol Education Panel Adult Treatment Panel III (NCEP) guidelines and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). A study demonstrated that only 38% of patients achieved NCEP ATP II LDL-C goals. Success rates were the lowest among those patients who could benefit most from therapy (18% of those patients with Coronary Heart Disease (CHD)). Additionally the most recent National Health and Nutrition Examination Survey (NHANES) report documented that only 34% of patients with high blood pressure are controlled.

Study Methods:

A retrospective chart review was conducted. Patients were identified ideally by medical claims data based upon NDC codes of targeted medications or office through a medical claims review for hypertension, hyperlipidemia, post-MI and post-stroke. 150 charts were randomly selected and analyzed to produce a goal of 100 evaluable patients.

Medications Reviewed:

• Lipitor (atorvastatin)

• Pravachol (pravastatin)

• Lescol (fluvastatin)

• Zocor (simvastatin)

• Crestor (rosuvastatin)

• Lovastatin

Conclusion:

The NCEP ATP III goal attainment among patients who receive care from HeartSafe providers is well above the national average (64.8% versus 38% LDL-C goals). In addition, treatment for hypertension and attainment of blood pressure goals in patients with hypertension were much higher than those reported from the most recent NHANES report (94.4% and 57% compared to 59% and 34% respectively).

HeartSafe's superior results are illustrated in the tables below and the HeartSafe healthcare staff has been nationally recognized for their superior management of patient cardiovascular risks.

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