Adherence to preferable behavior for lipid control by high-risk dyslipidemic Japanese patients under pravastatin treatment: the APPROACH-J study

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. 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. results: a total of 5,792 patients taking pravastatin were included in the analysis. multiple regression analysis showed a significant correlation in terms of intake of high fat/cholesterol/sugar foods (regression coefficient -0.58,p=0.0105) and adherence to instructions for drug therapy (regression coefficient -6.61,p<0.0001). low-density lipoprotein cholesterol (ldl-c) values were significantly lower in patients who had an increase in the adherence score in the awareness of health domain compared with those with a decreased score. there was a significant correlation between high-density lipoprotein (hdl-c) values and awareness of health (regression coefficient 0.26; p=0.0037),preferable dietary behaviors (regression coefficient 0.75; p<0.0001),and exercise (regression coefficient 0.73; p=0.0002). similar relations were seen with triglycerides. conclusion: in patients who have a high awareness of their health,a positive attitude toward lipidlowering treatment including diet,exercise,and high adherence to drug therapy,is related with favorable overall lipid control even in patients under treatment with pravastatin.