Atorvastatin-Therapie in der Praxis – LDL-Werte bei Patienten mit sehr hohem kardiovaskulären Risiko

2017 ◽  
Vol 142 (16) ◽  
pp. 1249-1252
Author(s):  
Ulrich Laufs ◽  
Christina Jannowitz ◽  
David Pittrow
Keyword(s):  
Cardiovascular Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Subjective Assessment ◽  
Cross Sectional Study ◽  
High Cardiovascular Risk ◽  
Cross Sectional ◽  
Current Guidelines ◽  
Very High

AbstractCurrent information on the utilisation of atorvastatin under clinical practice conditions is limited. The cross sectional study DISCOVER documented in the period from June until December 2014 dose and effects on lipids in ambulatory patients at very high cardiovascular risk, who were treated with atorvastatin monotherapy (original drug or generics). Of 2625 patients (mean age 66.1 ± 10.8 years, 62.1 % males), 47.0 % had coronary heart disease (CHD), 25.1 % type 2 diabetes mellitus (DM), and 27.9 % CHD plus concomitant DM. Mean treatment duration on atorvastatin was 92.6 ± 109.6 weeks, mean atorvastatin dose at time of documentation was 27.9 ± 15.8 mg/d. Low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL was achieved by 10.5 % of the total cohort (7.5 % in DM, 9.3 % in CHD, and 15.2 % in CHD+DM). In contrast, according to physicians’ subjective assessment, 62.7 % of patients reached their individual LDL-C target (with small differences between groups). In conclusion, the LDL-C target level < 70 mg/dL as recommended by current guidelines is achieved only in a minority of atorvastatin treated patients at very high cardiovascular risk.

Abstract 15830: Uncontrolled and Undertreated Cholesterol in Patients With Severe Hypercholesterolemia at a Large Healthcare System

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Catherine P Benziger ◽  
Nicole Groth
Keyword(s):  
High Intensity ◽  
Cardiovascular Health ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
The Past ◽  
Current Guidelines ◽  
Very High

Introduction: Patients with phenotypic severe hypercholesterolemia (SH) (low-density lipoprotein-cholesterol (LDL-c) ≥ 190 mg/dL), should have at least 50% LDL-c lowering by treatment with a maximally tolerated statin to goal LDL-c<100 mg/dL for primary prevention. Despite even more aggressive goals in Europe, these targets are not widely implemented. Methods: Cross-sectional study using an electronic medical record-based SH registry defined by ever having an LDL-c ≥ 190 mg/dL from 01/01/2000-01/16/2020 (n=17,925) at Essentia Health (MN, WI, and ND). Patients excluded if they had no visit at EH within the past 5 years (n=274), were <20 or >75 years old (n=3,171) or deceased (n=34). Results: We included 14,661 SH patients (81.1%) (mean age 59.8 ± 10.3 years; 58.9% female). A total of 40.7% were untreated for SH, 23.2% on a high-intensity statin, and 0.4% on proprotein convertase subtilisin/kexin type 9 inhibitor. Statins were prescribed in 31.8%, 47.9%, 56.1% and 65.4% of patients aged 20-39, 40-49, and 50-59, 60-75 years, respectively. There were 1,111 with a highest ever LDL-c > 250 mg/dL (32.8% not currently on lipid medication (n=365) and 14.5% of this group had LDL-c<100 mg/dL. Overall, 25.0% achieved at least 50% LDL-lowering (Table 1) and 19.8%, a most recent LDL-c<100 mg/dL; 64.1% of men and 69.5% of women treated with any lipid medication still had an elevated LDL-c. In the no medication group, only 17.2% (n=1,025) had a statin allergy/intolerance. Females were less likely to be on a statin than males (p<0.001). High-intensity statin was the strongest predictor of an LDL-c at goal, then highest ideal cardiovascular health score (adjusted RR 13.2; 95% CI: 11.1-15.6). Conclusions: Majority of patients at very high risk of CVD with SH remain untreated or undertreated with recent LDL-c levels above target. It is necessary to obtain better control of lipid levels in patients already being treated, increase the detection of SH and improve adherence to the current guidelines.

scholarly journals The Prevalence of Cardiovascular Risk Factors among Polish Soldiers: The Results from the MIL-SCORE Program

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Grzegorz Gielerak ◽  
Paweł Krzesiński ◽  
Katarzyna Piotrowicz ◽  
Piotr Murawski ◽  
Andrzej Skrobowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pressure Control ◽  
Cross Sectional Study ◽  
Lipoprotein Cholesterol ◽  
Risk Scores ◽  
Cross Sectional

The MIL-SCORE (Equalization of Accessibility to Cardiology Prophylaxis and Care for Professional Soldiers) program was designed to assess the prevalence and management of cardiovascular risk factors in a population of Polish soldiers. We aimed to describe the prevalence of cardiovascular risk factors in the MIL-SCORE population with respect to age. This observational cross-sectional study enrolled 6440 soldiers (97% male) who underwent a medical history, physical examination, and laboratory tests to assess cardiovascular risk. Almost half of the recruited soldiers were past or current smokers (46%). A sedentary lifestyle was reported in almost one-third of those over 40 years of age. The prevalence of hypertension in a subgroup over 50 years of age was almost 45%. However, the percentage of unsatisfactory blood pressure control was higher among soldiers below 40 years of age. The prevalence of overweight and obese soldiers increased with age and reached 58% and 27%, respectively, in those over 50 years of age. Total cholesterol was increased in over one-half of subjects, and the prevalence of abnormal low-density lipoprotein cholesterol was even higher (60%). Triglycerides were increased in 36% of soldiers, and low high-density lipoprotein cholesterol and hyperglycemia were reported in 13% and 16% of soldiers, respectively. In the >50 years of age subgroup, high and very high cardiovascular risk scores were observed in almost one-third of soldiers. The relative risk assessed in younger subgroups was moderate or high. The results from the MIL-SCORE program suggest that Polish soldiers have multiple cardiovascular risk factors and mirror trends seen in the general population. Preventive programs aimed at early cardiovascular risk assessment and modification are strongly needed in this population.

scholarly journals Dyslipidemia and cardiovascular risk in Afro-descendants: a study of the Quilombola communities in Maranhão, Brazil

2015 ◽  
Vol 10 (36) ◽  
Author(s):  
Maria do Carmo Lacerda Barbosa ◽  
José Bonifácio Barbosa ◽  
Luis Felipe Alves Guerra ◽  
Mirza Ferreira Lima Barbosa ◽  
Felipe Lacerda Barbosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Lipoprotein Cholesterol ◽  
Cardiovascular Risks ◽  
Cross Sectional ◽  
Factors Associated ◽  
Low Prevalence

Objective: to evaluate the prevalence of cardiovascular risk factors associated with dyslipidemia in Quilombola communities in Maranhão, Brazil. Methods: a cross-sectional study was performed from February 2010 to November 2011. A total of 202 individuals belonging to the Quilombola communities in Codó, Maranhão were assessed. Risk factors associated with dyslipidemia and metabolic syndrome (MS) were evaluated. Results: the results showed a high prevalence of dyslipidemia (72.28%) and hypertension (43.07%). Isolated hypertriglyceridemia (38.61%) with normal levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol was present in most individuals. Furthermore, the prevalence of MS and the estimated cardiovascular risks were low in this population. Conclusion: dyslipidemia, at the expense of triglycerides, and hypertension was highly prevalent. However, the frequency of other risk factors for cardiovascular events was low. A low prevalence of MS and cardiovascular risk according to the Framingham score for cardiovascular diseases was also identified.

scholarly journals Interaction between CETP polymorphism and dietary insulin index and load in relation to cardiovascular risk factors in diabetic adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Faezeh Abaj ◽  
Masoumeh Rafiee ◽  
Fariba Koohdani
Keyword(s):  
Risk Factors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional

AbstractGene–diet interactions may play an important role in the inter individual diversity observed in on cardiovascular disease (CVD) risk factors. Therefore, in the current study, we examined the interaction of CETP TaqB1 polymorphism with dietary insulin index and load (DII and DIL), in altering on CVD risk factors among type 2 diabetes mellitus (T2DM). In this cross-sectional study, blood samples were collected from 220 type 2 diabetic patients (134 females and 86 male) with a mean age of 52.24 years in Tehran, Iran. DIL and DII were obtained via validated food-frequency questionnaire (FFQ). Taq1B polymorphism was genotyped by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Biochemical markers including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), superoxide dismutase (SOD), C-reactive protein (CRP), total antioxidant capacity (TAC), pentraxin-3 (PTX3), isoprostaneF2α (PGF2α). interleukin 18 (IL18), leptin and ghrelin were measured by standard protocol. Patients with B1B1 genotype had lower lipid profiles include LDL/HDL (P < 0.001) and TG (P = 0.04) when they consumed diets higher on the DIL and DII index. Moreover, carriers of B2B2 genotype who were in the last tertile of DIL had higher antioxidant and inflammatory markers include SOD (P = 0.01), PGF2α (P = 0.04) and CRP (P = 0.02). Further, a significant interaction between CETP TaqB1 and DII was shown in terms of WC (P = 0.01), where the highest WC were observed in B2B2 genotype carriers following a DII score. However, the highest inflammatory and antioxidant markers include CRP (P = 0.04), TAC (P = 0.01), SOD (P = 0.02), and PGF2α (P = 0.02) were observed in B2B2 genotype carriers when they consumed diets higher on the DII index. Based on the current study, it could be proposed that CETP polymorphism may be associated with CVD risk factors in T2DM patients with high following insulin indices, including DII and DIL. It seems that CETP Taq1B polymorphism can invert the result produced by insulin. This conclusion illustrates that the CETP Taq1B B1 allele could counteract the CVD risk induced by high DII and DIL.

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