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Hyperlipidemia is regarded as main cause of coronary heart disease (CHD) or other forms of atherosclerotic vascular diseases. Clinical trials demonstrated that lowering serum cholesterol levels reduced new CHD events and CHD mortality in primary prevention and morbidity and mortality from CHD in secondary prevention. The objective of this study is to evaluate the use of hypolipidemic agents in Boramae Hospital. A total of 176 outpatients on hypolipidemic agents (lovastatin, simvastatin, gemfibrozil and cholestyramine) at Boramae Hospital from January 1997 to December 2000 were reviewed at least for one year retrospectively. The criteria of drug use evaluation were based on the standard of the American Society of Health-System Pharmacists and modified to fit out hospital settings. As results, 86.4% were met with criteria for the justification for use. In analyzing critical indicators, 88.1% had taken HMG-CoA reductase inhibitors for the first medication. The appropriateness was low in terms of laboratory tests for monitoring adverse events, follow-up for measuring serum cholesterol levels, instruction on lifestyle modification and drug information. The main complications were gastrointestinal effects which were found in 31 patients (17.6%). In outcome measures, 69.3% were met with criteria in all patients, but 41.7% were met with criteria in patients with coronary heart disease. Considering clinical importance of secondary prevention, it is necessary to implement the intensive treatment and monitoring in order to decrease LDL cholesterol level of 100㎎/㎗ or lower in patients with coronary heart disease. Because hyperlipidemia is a chronic state and obvious cause of fatal cardiovascular events, pharmacists have to participate in patient care more actively to improve the therapeutic effectiveness and assure quality of life.
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