scholarly journals Age and gender disparities in the prevalence of lipitension

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y U Grinshtein ◽  
R Ruf ◽  
V Shabalin
Keyword(s):  
Blood Pressure ◽  
Density Lipoprotein ◽  
Gender Disparities ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Krasnoyarsk Krai ◽  
Age Group ◽  
Age And Gender ◽  
Lipoprotein Level ◽  
And Gender

Abstract Introduction Lipitension is the presence of hypertension and dyslipidaemia in one person. It multiplies cardiovascular risk up to three-fold and therefore requires timely diagnosing and treatment. Purpose In the present study, we calculated the prevalence of lipitension and its disparities depending on gender and age. Methods We used the randomized sample of the ESSE-RF study that included 1603 urban and rural Krasnoyarsk Krai inhabitants aged 25–64. Each study participant signed informed consent and underwent the questionnaire, office blood pressure measurement, anthropometry, and biochemical blood analysis. Hypertension criteria were the measured systolic blood pressure at 140 mm Hg or higher, the measured diastolic blood pressure at 90 mm Hg or higher, or antihypertensive medications intake. Dyslipidaemia criteria were the total cholesterol level higher than 5.0 mmol/l, the low-density lipoprotein level higher than 3.0 mmol/l, the high-density lipoprotein level lower than 1.0 mmol/l in males and 1.2 mmol/l in females, or triglycerides level higher than 1.7 mmol/l. Results In 40.0% of people, we found a combination of at least one hypertension criterion and at least one dyslipidaemia criterion. The prevalence of lipitension significantly (chi-square for trend; p<0.001) increased from 10.7% in the 25–34 age group to 66.6% in the 55–64 age group. At a younger age, males had dyslipidaemia more frequently than females, while at 55–64, the prevalence of lipitension was higher in females. The details of age and gender disparities are shown in Table 1. Conclusion At least 40% of the general population and two-thirds of people older than 55 have lipitension and need a combined antihypertensive and lipid-lowering therapy. FUNDunding Acknowledgement Type of funding sources: None. Table 1

scholarly journals Age- and Gender-Related Differences in LDL-Cholesterol Management in Outpatients with Type 2 Diabetes Mellitus

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Giuseppina Russo ◽  
Basilio Pintaudi ◽  
Carlo Giorda ◽  
Giuseppe Lucisano ◽  
Antonio Nicolucci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Diabetes Duration ◽  
Lipid Lowering ◽  
Age And Gender ◽  
Chd Risk ◽  
And Gender

Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men.Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM.Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P<0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups.Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.

Abstract P320: Gender Disparities in Low Density Lipoprotein (LDL) Control for Secondary Prevention Among Patients with Coronary Heart Disease (CHD): Does Having a Caregiver Matter?

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Gmerice Hammond ◽  
Heidi Mochari-Greenberger ◽  
Ming Liao ◽  
Lori Mosca
Keyword(s):  
Secondary Prevention ◽  
Gender Gap ◽  
Medical Center ◽  
Academic Medical Center ◽  
Density Lipoprotein ◽  
Gender Disparities ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Multivariable Adjustment ◽  
Statin Use

Background: Despite the proven benefits of lipid lowering therapy for the prevention of recurrent CHD, research has consistently shown that women are less likely than men to be at established LDL targets. The reasons for the gender gap remain elusive. The purpose of this study was to test the hypothesis that having a caregiver is independently associated with adherence to Adult Treatment Panel (ATP) III LDL goals for secondary prevention, and to determine if the association varies by gender. Methods: We studied 2190 consecutive patients admitted to the cardiac service of an academic medical center as part of the NHLBI sponsored Family Cardiac Caregiver Investigation To Evaluate Outcomes (FIT-O) Study (93% participation rate). Patients with CHD or equivalent, and a documented LDL within 12 months of admission were included in this analysis (58% white, 66% male, mean age 67 yrs). Caregiver status was assessed by a standardized interviewer-assisted questionnaire and was classified as either paid (nurse/home aide) or informal (family member/friend). Lipid levels and statin use were obtained from a hospital-based informatics system and medical chart review. ATP III targets were classified as target (LDL<100 mg/dL) and aggressive target (LDL<70 mg/dL). The associations between caregiving and LDL were assessed using chi square statistics, overall and stratified by gender. Multivariable regression was used to adjust for confounders (age, marital status, race, gender, health insurance, statin use, comorbidities). Results: Males with CHD were more likely than females with CHD to be at target LDL <100 [79% (1149/1446) vs 69% (515/744) respectively; p=0.0001], and at LDL<70 [48% (688/1446) vs 36% (271/744); p<0.0001]. The prevalence of caregiving overall was 40% (N= 879/2190; 13% paid; 27% informal only), and did not differ by gender. Having an informal caregiver was significantly associated with LDL<70 (OR=1.35; 95%CI=1.07-1.70), and this remained significant after multivariable adjustment for confounders (OR=1.25; 95% CI=1.00-1.56). The association between caregiving and LDL<100 did not reach significance (OR=1.20; 95% CI=0.95-1.51). In stratified analysis, men with an informal caregiver were more likely than men without a caregiver to have an LDL<70 (OR=1.35; 95%CI=1.07-1.70); this remained significant after multivariable adjustment for confounders, including statin use (OR=1.37; 95%CI=1.04-1.80). The relation between caregiving and LDL control was not significant among women. Conclusion: Men with CHD were more likely to be at ATP III targets LDL <70 and <100 mg/dL than women with CHD. Having an informal caregiver was a significant predictor of being at aggressive target LDL <70mg/dL among men but not among women, even after adjustment for confounders. The potential role of caregiving as a novel contributor to gender disparities in LDL control deserves further study.

scholarly journals The prevalence of metabolic syndrome in the Krasnoyarsk Krai population and the features of its association with hyperuricemia

2020 ◽  
Vol 25 (6) ◽  
pp. 3852
Author(s):  
Yu. I. Grinshtein ◽  
V. V. Shabalin ◽  
R. R. Ruf ◽  
S. A. Shalnova
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Representative Sample ◽  
Basic Education ◽  
Education Level ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Krasnoyarsk Krai ◽  
Rural Residents ◽  
Total Prevalence

Aim. To study the prevalence of metabolic syndrome (MS) and its components, as well as their relationship with hyperuricemia (HU) in a representative sample of the Krasnoyarsk Krai.Material and methods. As part of a multicenter epidemiological study ESSE-RF, a representative sample of 1603 residents of the Krasnoyarsk Krai aged 25-64 was randomized. All subjects underwent a questionnaire survey, anthropometry, office blood pressure (BP) measurement, determining the levels of blood lipids, plasma glucose and serum uric acid. MS was diagnosed according to the modified NCEP ATP III criteria (2005). Statistical processing was carried out using the software package IBM SPSS v 22.Results. The total prevalence of MS was 26,8%; higher in women than in men (29,4% vs 22,9%). With age, the prevalence of MS significantly increased — from 6,9% in subjects aged 25-34 years to 45,2% in people 55-64 years old. The prevalence of MS was significantly higher among rural residents compared with urban ones (36,8% vs 23,1%). Education level significantly affected prevalence of MS: in people with basic education, MS was found in 35,7%, with secondary — in 30,3%, with higher — in 17,8%. Regression analysis showed that hypertriglyceridemia, blood pressure >130/85 mm Hg and glucose ≥5,6 mmol/l were a significant predictors of HU in all subjects. For men, significant predictors of HU were hypertriglyceridemia and abdominal obesity, and for women — glucose ≥5,6 mmol/l and lipid-lowering therapy.Conclusion. The prevalence of MS in the Krasnoyarsk Krai, according to the modified NCEP ATP III criteria (2005), is 26,8%. MS is more often recorded in women than in men and in rural residents than in urban ones. With an increase in the education level, MS is less common. With age, the prevalence of MS significantly increases. The correlation of HU is not revealed with all the components of MS and has sex differences.

Prevalence, specialized ambulatory care and guideline-recommended therapy of peripheral vascular diseases in Germany

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Rammos ◽  
O Petrikhovich ◽  
A Mahabadi ◽  
M Steinmetz ◽  
J Lortz ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Ambulatory Care ◽  
Primary Care Physicians ◽  
Lipid Lowering ◽  
Age Group ◽  
Age And Gender ◽  
And Gender ◽  
Gender Specific ◽  
Recommended Therapy

Abstract Background Cardiovascular diseases are the leading causes of death in the industrialized world. In addition to coronary heart disease, PAD defines morbidity and is associated with increased mortality. Guideline-recommended therapy and specialized ambulatory care is essential for optimal treatment. Knowledge of the treatment structures, contact with dedicated specialists and pharmacotherapy in the outpatient area are essential for improving treatment, reducing symptoms and finally improve mortality in this high-risk population. Methods The study is based on the ambulatory claims data of the panel doctors services according to § 295 SGB V and drug prescription data according to § 300 SGB V. The prevalence of PAD in Germany (medical diagnoses of PAD ICD I70.2–9) was analyzed by age and gender-specific characteristics with a timeframe of 10 years (2009–2018). In addition, the current ambulatory care structure was examined subdivided by vascular specialist (vascular surgeons or angiologists) and primary care physicians (internal medicine or general practitioners). Additionally, the prescription of guideline-recommended pharmacotherapy like statins and antiplatelet inhibitors was analyzed for the years 2009–2016. Results An increase of PAD diagnosis was observed with a maximum in 2018 with 2.280.000 patients in Germany. The rise of PAD patients strongly correlates with increased age (age group 50–59: 243.000, age group 60–69: 533.000, age group 70–79: 735.000, age group 75–79: 438.000, age group 80–89: 710.000) and more commonly affects males (55%) than females (45%). Access to vascular specialist was low for all age groups with only 11% of patients receiving care from vascular surgeons and only 9% from angiologists. However, 99% received care by a primary care physician. The prescription of lipid-lowering drugs and platelet aggregation inhibitors in the current analysis period from 2009–2016 is insufficient, with only 46% receiving statins and 29% receiving antiplatelets and 15% oral anticoagulation, Conclusion There are relevant differences in age and gender-specific prevalence of PAD in Germany. In addition to the regular care provided by primary care physicians, PAD patients are in need for specialized vascular care. Guideline recommended prescriptions are alarmingly low in PAD patients. There is a clear need to improve the treatment algorithms in the high-risk PAD population. Funding Acknowledgement Type of funding source: None

scholarly journals Triple-combined hypolipidaemic therapy in familial hypercholesterolaemia: clinical cases

2021 ◽  
Vol 28 (5) ◽  
pp. 117-130
Author(s):  
Svetlana A. Chepurnenko ◽  
Galina V. Shavkuta ◽  
Alina V. Safonova
Keyword(s):  
Blood Pressure ◽  
Ldl Cholesterol ◽  
Familial Hypercholesterolaemia ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Premature Cardiovascular Disease ◽  
Clinical Cases

Background. The prevalence of heterozygous familial hypercholesterolaemia (HeFH) comprises 1 per 250 people. The risk of premature cardiovascular disease (CVD) is 20 times higher in HeFH patients among the general population. CVD develops in HeFH patients under 20 years of age, and they usually do not survive to 30 years. Therefore, the primary treatment track here is correction of dyslipidaemia to prevent atherosclerosis progression and CVD. Clinical Case Descriptions. The article describes the clinical cases of familial dyslipidaemia in 47-yo patient M. and his 75-yo mother P. The patient had a visit related to blood pressure (BP) surges up to 140/90 mm Hg. In history: acute myocardial infarction (AMI) in maternal grandfather at 50 years and own uncle at 32 years. The patient’s cardiovascular risk factors: male gender, dyslipidaemia (total cholesterol (TC) 15.8 mmol/L), overweight (body mass index 29.9 kg/m2), familial history of young CVD, sedentary lifestyle (employed as manager), psychological and socioeconomic factors (work-related stress pressure), resting heart rate 88 beats/min. The patient was immediately ordered a combined hypolipidaemic therapy including rosuvastatin 20 mg, ezetimibe 10 mg, telmisartan 40 mg once daily for blood pressure correction. In 1-month therapy, cholesterol dropped to 4.4 mmol/L, low-density lipoprotein (LDL) cholesterol – to 2.2, but triglycerides remained high at 3.9 mmol/L. Fenofi brate added to therapy at 145 mg 1 time. Another 1-month therapy allowed the overall reduction of TC to 3.7, LDL cholesterol to 1.9, triglycerides to 2.17 and high-density lipoproteins to 1.19 mmol/L. Past 3 months, a further drop was observed in triglycerides to 1.7 mmol/L. Hence, a triple hypolipidaemic therapy facilitated the target LDL and triglyceride values without involving expensive medications like PCSK9 blockers. The patient’s mother also achieved the target basic lipidogram owing to a triple lipid-lowering therapy.Conclusion. The case is of interest to exemplify a successful triple lipid-lowering therapy in patients with familial hypercholesterolaemia.

Structure and Function of Proprotein Convertase Subtilisin/kexin Type 9 (PCSK9) in Hyperlipidemia and Atherosclerosis

2019 ◽  
Vol 20 (10) ◽  
pp. 1029-1040 ◽  
Author(s):  
Xinjie Lu
Keyword(s):  
Low Density Lipoprotein ◽  
Ldl Receptor ◽  
Density Lipoprotein ◽  
Structure And Function ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Proprotein Convertase ◽  
Novel Target ◽  
New Treatments ◽  
And Function

Background:One of the important factors in Low-Density Lipoprotein (LDL) metabolism is the LDL receptor (LDLR) by its capacity to bind and subsequently clear cholesterol derived from LDL (LDL-C) in the circulation. Proprotein Convertase Subtilisin-like Kexin type 9 (PCSK9) is a newly discovered serine protease that destroys LDLR in the liver and thereby controls the levels of LDL in plasma. Inhibition of PCSK9-mediated degradation of LDLR has, therefore, become a novel target for lipid-lowering therapy.Methods:We review the current understanding of the structure and function of PCSK9 as well as its implications for the treatment of hyperlipidemia and atherosclerosis.Results:New treatments such as monoclonal antibodies against PCSK9 may be useful agents to lower plasma levels of LDL and hence prevent atherosclerosis.Conclusion:PCSK9's mechanism of action is not yet fully clarified. However, treatments that target PCSK9 have shown striking early efficacy and promise to improve the lives of countless patients with hyperlipidemia and atherosclerosis.

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