New Survey Among European Cardiologists Points to a Gap in Cardiovascular Disease Management

Munich, Germany (ots/PRNewswire) -

- In spite of the success of therapies targeting LDL in lowering
cardiovascular risk, a residual risk still remains

Cardiologists in Europe agree that reducing LDL-cholesterol
(LDL-C or "bad" cholesterol) levels is the most important factor in
treating dyslipidemia (abnormal blood lipids) and reducing the risk
of a cardiovascular event. A majority of cardiologists also agree
that in addition to lowering LDL-C, raising HDL-cholesterol (HDL-C or
"good" cholesterol) and reducing triglycerides are important targets
in reducing cardiovascular risk. Yet, despite these views, physicians
are only treating one-third of their cardiovascular disease patients
based on all three lipid parameters. These findings, from a new TNS
Healthcare survey sponsored by Merck Sharp & Dohme (MSD), were
presented today at the 2008 European Society of Cardiology (ESC)
Annual Congress.

"Established clinical evidence on the value of reducing LDL-C has
driven the management of dyslipidemia over the past two decades,
resulting in a significant reduction in cardiovascular disease
mortality," said Anselm Kai Gitt, M.D., Vice Director of the
Myocardial Infarction Research Institute in Ludwigshafen, Germany.
"Despite these great strides, significant cardiovascular risk remains
for patients who have lowered their LDL-C levels through lifestyle
modification and medication. When treating a patient, we must
consider all risk factors including low HDL-C and triglycerides,
among others, and recommend appropriate intervention."

Research shows that lowering LDL-C with statin therapy may
decrease the risk of cardiovascular disease by about 25 to 40
percent. Other factors that contribute to cardiovascular risk include
low levels of HDL-C, high levels of triglycerides, hypertension,
diabetes, and obesity. According to the survey results, more than
two-thirds of cardiologists agree that despite lowering LDL-C levels,
a residual risk for cardiovascular events remains.

Gap between perception and practice in factors for treating
dyslipidemia

According to the survey results, 97 percent of respondents said
reducing LDL-C is a "fairly" or "extremely" important consideration
when choosing a treatment for dyslipidemia, and 84 percent said they
consider increasing HDL-C as either "fairly" or "extremely"
important. However, less than half (47 percent) of their patients are
treated for both of these lipids. Moreover, 66 percent said reducing
triglycerides is either "fairly" or "extremely" important. Only 29
percent of their patients, however, are treated based on all three
lipid parameters, despite the majority acknowledging that all three
lipids are risk factors for cardiovascular disease.

Cardiologists placed the greatest emphasis on LDL-C reduction and
lifestyle education. Even though 89 percent of cardiologists surveyed
agree that HDL-C is an important contributor to cardiovascular
disease, 10 percent or less believe that educating patients on
raising their good cholesterol is important.

"These findings reveal a strong belief in the importance of
treating beyond LDL-C alone to reduce the residual risk of
cardiovascular events in patients with dyslipidemia, yet this is not
adequately translating into clinical practice," said Dr. Gitt.
"Cardiologists are in a unique position to change this paradigm.
Armed with scientific knowledge, clinical experience and new
treatment advances, we can establish a comprehensive approach to
cardiovascular disease management."

About the survey

TNS Healthcare conducted an online questionnaire of a total of
507 cardiologists in France (n=101), Germany (n=100), Italy (n=100),
Spain (n=106), and the UK (n=100) between June 18 and July 30, 2008.
Cardiologists' practices ranged from hospital-based to office-based
to both hospital- and office-based in primarily urban areas.

Impact of three major lipids on cardiovascular risk factors

Cardiovascular disease (CVD) is a general term referring to
diseases that affect the heart or blood vessels. Coronary heart
disease (CHD), also known as coronary artery disease (CAD), is one of
the most common forms of CVD and is the leading cause of death
globally. Major risk factors for CVD include abnormal blood lipids,
meaning not only high LDL-C levels but also high levels of
triglycerides and low levels of HDL-C.

CVD is the main cause of death in Europe, accounting for more
than 4.9 million deaths (52 percent of all mortality) in 2002. Nearly
half of all deaths from CVD are from CHD (48 percent) and nearly
one-third are from stroke (29 percent). CHD by itself is the most
common cause of death in Europe, accounting for nearly 2.4 million
deaths each year.

About cholesterol

Cholesterol is one of several fatty substances (lipids) found in
the bloodstream. Total cholesterol is made up mainly of LDL-C and
HDL-C. LDL-C is often called "bad" cholesterol because it can build
up in the walls of the arteries and form plaque. Over time, the
plaque can clog the arteries, resulting in a heart attack or stroke.
HDL-C is often called "good" cholesterol because it is thought to
keep LDL-C from building up in the arteries, and because it appears
to protect against heart disease in other ways as well. Triglycerides
are another form of fat in the blood, and elevated levels may also
raise the risk of developing heart disease. The Pan-European Survey
(2005) found that about one-third of men and 40 percent of women have
low HDL-C levels, regardless of the use of lipid-modifying treatment
(primarily statins). Low HDL-C in combination with high triglycerides
is also common across Europe, where 22 percent of men and 25 percent
of women have abnormal levels of both lipids.

About Merck

Merck & Co., Inc. (Whitehouse Station, N.J., U.S.A.), which
operates in many countries as Merck Sharp & Dohme or MSD, is a global
research-driven pharmaceutical company dedicated to putting patients
first. Established in 1891, the Company currently discovers,
develops, manufactures and markets vaccines and medicines to address
unmet medical needs. The Company devotes extensive efforts to
increase access to medicines through far-reaching programs that not
only donate its medicines but help deliver them to the people who
need them. Merck also publishes unbiased health information as a
not-for-profit service.

ots Originaltext: Merck & Co., Inc.
Im Internet recherchierbar: http://www.presseportal.de

Contact:
Serena Thomson, +44-(0)7787-537370, for Merck & Co., Inc. NOTE TO
EDITORS: For further information regarding the survey results, please
refer to the accompanying fact sheet titled "EU Cardiology Survey."