Background and aim: In this multicentre observational study the "5-4-3-2-1" guideline (total cholesterol < 5.0 mmol/L, the ratio of total to high-density lipoprotein cholesterol < 4, low-density lipoprotein cholesterol < 3.0 mmol/L, triglycerides < 2.0 mmol/L and high-density lipoprotein cholesterol > 1.0 mmol/L) was compared with the new European recommendations (total cholesterol < 5.0 mmol/L and low-density lipoprotein cholesterol < 3.0 mmol/L) ("5-3") and a treatment criterion of low-density lipoprotein cholesterol < 3.0 mmol/L and triglycerides < 1.5 mmol/L ("3-1.5"), as patients with triglycerides > 1.5 mmol/L may have an increased risk of premature cardiovascular disease.
Methods and results: In 1997/98, 2134 patients in general practice with established atherosclerotic disease on a lipid-lowering therapy were monitored. The "5-4-3-2-1" guideline was met in 19.2% and the "5-3" guideline in 36.2% and 22.5% fulfilled the "3-1.5" criterion. Our data showed a good conformity between the "5-4-3-2-1" guideline and the "3-1.5" criterion. Of the patients who achieved the "5-3" guideline approximately 50% still had unfavourable values of HDL-cholesterol and TG, while only 15% of those who fulfilled the "3-1.5" criterion had HDL-cholesterol < or = 1.0 mmol/L.
Conclusions: A treatment goal of LDL-cholesterol < 3.0 mmol/L and fasting TG < 1.5 mmol/L markedly raised the proportion of patients with desirable levels of HDL-cholesterol and the ratio of total cholesterol to HDL-cholesterol and should be recommended in secondary prevention, especially in diabetic patients.