OBJECTIVE: The objective of this study was to evaluate the effects of various statin doses on the attainment of target LDL-Cholesterol (LDL-C) levels in clinical practice. METHODS: Patients newly initiated on atorvastatin, fluvastatin, pravastatin, or simvastatin from 1/99 to 6/99 were retrospectively identified from a southeastern U.S. health plan database. Exclusion criteria included statin therapy in the prior 6 months, less than 90 days of statin therapy, switching of statin, use of combination dyslipidemia therapy, and less than 18 months of continuous plan enrollment. For each statin dose, attainment of target LDL-C based on NCEP ATP II guidelines was analyzed using univariate (unadjusted) and multivariate (adjusted) logistic regression. Covariates utilized in the adjusted analysis were age, gender, presence of atherosclerotic vascular disease, and difference between baseline and target LDL-C. RESULTS: A total of 1938 statin dose episodes from 1645 eligible patients (mean age=66.3 ± 10.4 years, 47% male) were evaluated. Mean absolute (percent) LDL-C reductions across statin dose ranges were: atorvastatin [67-81 mg/dL (39-43%)], fluvastatin [34-42 mg/dL (21-26%)], pravastatin [39-45 mg/dL (24-26%)], and simvastatin [52-67 mg/dL (32-38%)]. In the unadjusted results, atorvastatin 20 mg, fluvastatin 20 mg and 40 mg, pravastatin 20 mg and 40 mg, and simvastatin 10 mg had significantly lower odds of attaining NCEP II LDL-C target when compared to atorvastatin 10 mg. In the adjusted results, fluvastatin 20 mg and 40 mg, pravastatin 20 mg and 40 mg, and simvastatin 10 mg and 20 mg had significantly lower odds of attaining NCEP II LDL-C target as compared to atorvastatin 10 mg. CONCLUSIONS: Patients prescribed atorvastatin 10 mg had greater odds of attaining their target LDL-C level than patients prescribed all other statin doses in the adjusted analysis except for simvastatin 40 mg and atorvastatin 20 mg.