The gender differences in baseline characteristics and statin intervention among outpatients with coronary heart disease in China: the China Cholesterol Education Program

Clin Cardiol. 2009 Jun;32(6):308-14. doi: 10.1002/clc.20514.


Background: The China Cholesterol Education Program (CCEP) aimed to investigate the baseline characteristics of outpatients with coronary heart disease (CHD) according to gender, especially lipid levels, statin intervention, and rates of achieving their goal low-density lipoprotein cholesterol (LDL-C) level.

Methods: A total of 4778 CHD outpatients were enrolled from 52 centers in 6 Chinese cities from January 2006 to January 2007.

Results: Female outpatients were significantly older than male outpatients (66+/-10 vs 63+/-11 years, P <0.001). Male outpatients were more likely to smoke than female outpatients (P<0.001). Female outpatients had a higher prevalence of hypertension, diabetes mellitus, LDL-C level, and total cholesterol level (all P values <0.001). About 82% of the participants received statin therapy. The LDL-C levels were 3.06+/-1.08 mmol/L and 2.89+/-0.97 mmol/L in outpatients at high risk and very high risk respectively (P<0.001). Though there were higher rates of statin intervention, only 36.2% of the high risk outpatients got to the target LDL-C level (<2.6 mmol/L); 10.9% of the very high risk outpatients achieved the optimal LDL-C level (<1.82 mmol/L) suggested by National Cholesterol Education Program Adult Treatment Panel III. The rate of achieving target was only 42.2%, even when LDL-C <2.6 mmol/L was the target level for patients at very high risk. Only 19.4% of the outpatients at very high risk achieved the target (LDL-C <2.08 mmol/L) suggested by the updated Chinese guideline for CHD.

Conclusion: Although the outpatients received a higher rate of statin therapy, the rates of achieving the target were lower. There is still a significant gap between the guidelines and clinical practice in statin intervention among these CHD outpatients, particularly for women.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Ambulatory Care* / statistics & numerical data
  • Asian People
  • Biomarkers / blood
  • China / epidemiology
  • Coronary Disease / blood
  • Coronary Disease / drug therapy*
  • Coronary Disease / ethnology
  • Coronary Disease / etiology
  • Cross-Sectional Studies
  • Female
  • Guideline Adherence
  • Health Care Surveys
  • Health Education* / statistics & numerical data
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Lipids / blood*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Program Evaluation
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Treatment Outcome


  • Biomarkers
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids