Previous work from the European Society of Cardiology (ESC), the European Atherosclerosis Society (EAS) and from other groups has addressed the benefits of statin treatment in different patient populations.1–4 Unfortunately, adherence to guideline-recommended statin therapy is suboptimal: Statins are underused and LDL cholesterol targets are not met in up to 80% of high-risk patients.5–7 Excellent reviews have recently been published on the issue of statin intolerance and some lay media as well strongly emphasize this issue.8 True and verified statin intolerance, however, is uncommon and is not the main reason for poor adherence to statin treatment. Because poor adherence to statin treatment in turn is extremely common, it appears necessary to discuss the problem of statin adherence in a broader context and to develop strategies to overcome it. This clinically important task has not yet been the focus of a review or practice recommendation and therefore is the aim of the present position paper from the ESC working group on Cardiovascular Pharmacotherapy. This work takes the position that statin therapy is underutilized because of non-adherence not solely related to statin side effects and proposes steps to be taken in cardiovascular practice to improve statin adherence and thus cardiovascular outcomes. Our article aims to highlight the scientific background that helps to (i) overcome statin non-adherence by definition and description of true adverse statin effects, (ii) increase statin adherence by changing reservation against lipid lowering in media and the public, and (iii) guide efforts in the scientific community to close the gap between knowledge and practice of lipid management. Although statins are generally well-tolerated, statin adherence is poor in clinical practice: A survey of statin prescription claims showed a 30% discontinuation rate within the first year following initial prescription for primary prevention in USA.9 Data from the Danish …

中文翻译：

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提高对他汀类药物治疗依从性的综合努力

欧洲心脏病学会 (ESC)、欧洲动脉粥样硬化学会 (EAS) 和其他团体之前的工作已经解决了他汀类药物治疗对不同患者人群的益处。 1-4 不幸的是，对指南推荐的他汀类药物治疗的依从性并不理想：他汀类药物使用不足，并且高达 80% 的高危患者未达到 LDL 胆固醇目标。5-7 最近发表了关于他汀类药物不耐受问题的优秀评论，一些非专业媒体也强烈强调了这个问题。8 正确且然而，经证实的他汀类药物不耐受并不常见，并且不是他汀类药物治疗依从性差的主要原因。由于对他汀类药物治疗依从性差非常普遍，因此似乎有必要在更广泛的背景下讨论他汀类药物依从性问题并制定克服该问题的策略。这项具有临床意义的任务尚未成为审查或实践建议的重点，因此是 ESC 心血管药物治疗工作组当前立场文件的目标。这项工作认为他汀类药物治疗未得到充分利用，因为不依从性不仅与他汀类药物的副作用有关，并提出了在心血管实践中应采取的措施，以改善他汀类药物的依从性，从而改善心血管结局。我们的文章旨在强调有助于 (i) 通过定义和描述真正的他汀类药物不良反应来克服他汀类药物不依从性的科学背景，(ii) 通过改变媒体和公众对降脂的保留来增加他汀类药物的依从性，以及 (iii) ) 指导科学界努力缩小脂质管理知识与实践之间的差距。