Prevalence and predictors of lipid abnormalities in patients treated with statins in the UK general practice

被引:25
作者
Phatak, H. [1 ]
Wentworth, C. [2 ]
Sazonov, V. [1 ]
Burke, T. [1 ]
机构
[1] Merck & Co Inc, Whitehouse Stn, NJ 08889 USA
[2] Analyt Consulting Solut, Wakefield, RI USA
关键词
UK general practice; HDL-C; TG; CORONARY-HEART-DISEASE; DENSITY-LIPOPROTEIN CHOLESTEROL; 10-YEAR FOLLOW-UP; RISK; TRIGLYCERIDES; PREVENTION; MANAGEMENT; SECONDARY; EVENTS;
D O I
10.1016/j.atherosclerosis.2008.03.016
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To identify the prevalence and predictors of lipid abnormalities in statin-treated patients in the UK. Methods: A retrospective cohort study was performed using g the UK General Practice Research Database. Patients >= 35 years of age were included if they received first-ever statin between January 2000 and December 2004, received statins for at least 6 weeks. had >2 years of pre- and I year of post-statin initiation database history. received no concomitant lipid lowering drugs and had at least one complete lipid profile conducted within 1 year before and after initiating statins. Predictors of each lipid abnormality were determined using random effects logistic regression. Results: Within 1 year of statin initiation. 34.7%, 27.4%, 68.2% and 57.6% of patients did not reach optimal levels of TC, LDL-C, HDL-C and TG. respectively. Failure to attain TC goal was explained by smoking (odds ratio = 1.13. 95% confidence interval [1.02-1.23]) and baseline TC >6.2 mmol/L (5.01 [4.58-5.48]). Failure to attain LDL-C goal was associated with smoking (1.28, [1.14-1.43]). LDL-C >= 4.1 to <4.9 mmol/L (2.72, [2.45-3.03]) and LDL-C >= 4.9 mmol/L (8.54, [7.62-9.54]). High CHD) risk was associated with low HDL-C in women at follow-up (1.94, [1.51-2.48]). Elevated TG was associated with baseline TG >= 2.2 to <5.6 mmol/L (4.19, [3.81-4.59]), TG >= 5.6 mmol/L (16.10. [3.67-70.57]). smoking, (1.26. [1.11-1.42]) and hypertension (1.12, [1.01-1.23]). Conclusion: While TC and LDL-C management appear appropriate in the UK. attainment of recommended levels of HDL-C and TG remains poor. The latter remains a concern, as pool-attainment of recommended levels of HDL-C and TG is associated with high CHD risk in women, smoking, and hypertension. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:225 / 233
页数:9
相关论文
共 30 条
  • [1] CARDIOVASCULAR-DISEASE RISK PROFILES
    ANDERSON, KM
    ODELL, PM
    WILSON, PWF
    KANNEL, WB
    [J]. AMERICAN HEART JOURNAL, 1991, 121 (01) : 293 - 298
  • [2] Assmann G, 1998, EUR HEART J, V19, pA2
  • [3] Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the Prospective Cardiovascular Munster (PROCAM) study
    Assmann, G
    Cullen, P
    Schulte, H
    [J]. CIRCULATION, 2002, 105 (03) : 310 - 315
  • [4] Backer G, 2003, EUR J CARDIOVASC P S, V10, pS1
  • [5] HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events
    Barter, Philip
    Gotto, Antonio M.
    LaRosa, John C.
    Maroni, Jaman
    Szarek, Michael
    Grundy, Scott M.
    Kastelein, John J. P.
    Bittner, Vera
    Fruchart, Jean-Charles
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2007, 357 (13) : 1301 - 1310
  • [6] Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds - A meta-analysis of randomized controlled trials
    Birjmohun, RS
    Hutten, BA
    Kastelein, JJP
    Stroes, ESG
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 45 (02) : 185 - 197
  • [7] *BRIT HEART FDN, 2003, DEATHS CAUS SEX AG
  • [8] THE TRIGLYCERIDE ISSUE - A VIEW FROM FRAMINGHAM
    CASTELLI, WP
    [J]. AMERICAN HEART JOURNAL, 1986, 112 (02) : 432 - 437
  • [9] Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
    Cleeman, JI
    Grundy, SM
    Becker, D
    Clark, LT
    Cooper, RS
    Denke, MA
    Howard, WJ
    Hunninghake, DB
    Illingworth, DR
    Luepker, RV
    McBride, P
    McKenney, JM
    Pasternak, RC
    Stone, NJ
    Van Horn, L
    Brewer, HB
    Ernst, ND
    Gordon, D
    Levy, D
    Rifkind, B
    Rossouw, JE
    Savage, P
    Haffner, SM
    Orloff, DG
    Proschan, MA
    Schwartz, JS
    Sempos, CT
    Shero, ST
    Murray, EZ
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19): : 2486 - 2497
  • [10] Evidence that triglycerides are an independent coronary heart disease risk factor
    Cullen, P
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 2000, 86 (09) : 943 - 949