高胆固醇血症、降脂治疗的 eligibility 及治疗成功率：葡萄牙城市人群的基于人群的研究。注：原文中“eligibility”这里可能有误，推测可能是“eligibility criteria”之类的表述会更准确，可根据实际情况调整。整体翻译为“高胆固醇血症、降脂治疗的入选标准及治疗成功率：葡萄牙城市人群的基于人群的研究” 。

Hypercholesterolemia, eligibility for lipid-lowering therapy and therapeutic success: population-based study in a Portuguese urban population.

作者信息

Alves Luis, Azevedo Ana

机构信息

Department of Hygiene and Epidemiology, University of Porto Medical School, Institute of Public Health, Alameda Prof. Hernani Monteiro, 4200-319 Porto, Portugal.

出版信息

Eur J Endocrinol. 2008 Dec;159(6):755-60. doi: 10.1530/EJE-08-0487. Epub 2008 Sep 16.

DOI:10.1530/EJE-08-0487

PMID:18796541

Abstract

BACKGROUND

We aimed to estimate i) the prevalence of hypercholesterolemia, ii) the proportion of individuals eligible for treatment with lipid-lowering drugs, and iii) therapeutic success, according to the European guidelines on cardiovascular disease prevention in clinical practice.

DESIGN

Population-based cross-sectional study.

METHODS

We surveyed a representative sample of the population of Porto aged 40-65 years. Trained interviewers collected data from 1215 subjects (789 women) on demographic variables, medical history, and medication using structured questionnaires. A fasting venous blood sample was withdrawn. Subjects were considered low risk or high risk as indicated in the European guidelines. Hypercholesterolemia was defined as total cholesterol (TC) > or = 5 mmol/l or low-density-cholesterol (LDL-C) > or = 3 mmol/l in low-risk subjects, TC > or = 4.5 mmol/l or LDL-C > or = 2.5 mmol/l in high-risk subjects or being medicated with lipid-lowering drugs. Eligibility for treatment was defined as being high risk and having TC > or = 4.5 mmol/l, LDL-C > or = 2.5 mmol/l or being on treatment. We defined therapeutic success as having TC < 4.5 mmol/l and LDL-C < 2.5 mmol/l among medicated subjects.

RESULTS

Overall, 84.9% (95% confidence interval (95% CI): 82.7-86.8) of subjects had hypercholesterolemia and 9.1% (95% CI: 7.5-10.8) were medicated with lipid-lowering drugs. Men were more likely to be eligible for treatment (42.4%) than women (22.4%; OR=2.69, 95% CI 2.07-3.52). Therapeutic success was less frequent in men (46.8%) than in women (66.7%), (OR=0.39, 95% CI 0.17-0.87).

CONCLUSION

Strict interpretation of the European guidelines would label 85% of the general population in this age group as hypercholesterolemic and a third eligible for drug treatment. Questions arise regarding medicalization, resource allocation, and sustainability within the healthcare system.

摘要

背景

我们旨在根据欧洲临床实践心血管疾病预防指南，估计：i）高胆固醇血症的患病率；ii）符合使用降脂药物治疗条件的个体比例；iii）治疗成功率。

设计

基于人群的横断面研究。

方法

我们对波尔图市40 - 65岁的具有代表性的人群样本进行了调查。训练有素的访员使用结构化问卷收集了1215名受试者（789名女性）的人口统计学变量、病史和用药情况数据。采集了空腹静脉血样。根据欧洲指南，受试者被分为低风险或高风险。高胆固醇血症的定义为：低风险受试者总胆固醇（TC）≥5 mmol/l或低密度脂蛋白胆固醇（LDL-C）≥3 mmol/l；高风险受试者TC≥4.5 mmol/l或LDL-C≥2.5 mmol/l，或正在服用降脂药物。治疗条件的定义为高风险且TC≥4.5 mmol/l、LDL-C≥2.5 mmol/l或正在接受治疗。我们将治疗成功定义为接受药物治疗的受试者TC<4.5 mmol/l且LDL-C<2.5 mmol/l。

结果

总体而言，84.9%（95%置信区间（95%CI）：82.7 - 86.8）的受试者患有高胆固醇血症，9.1%（95%CI：7.5 - 10.8）正在服用降脂药物。男性比女性更有可能符合治疗条件（42.4%对22.4%；比值比=2.69，95%CI 2.07 - 3.52）。男性的治疗成功率（46.8%）低于女性（66.7%）（比值比=0.39，95%CI 0.17 - 0.87）。