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北加泰罗尼亚糖尿病研究中2型糖尿病患者群体中心血管疾病及危险因素的患病率

Prevalence of cardiovascular disease and risk factors in a type 2 diabetic population of the North Catalonia diabetes study.

作者信息

Jurado Jeronimo, Ybarra Juan, Solanas Pascual, Caula Jacint, Gich Ignasi, Pou Jose M, Romeo June Hart

机构信息

Primary Care, Catalan Health Institute, Olot, Girona, Spain.

出版信息

J Am Acad Nurse Pract. 2009 Mar;21(3):140-8. doi: 10.1111/j.1745-7599.2008.00377.x.

Abstract

PURPOSE

The purpose of the study was to evaluate the prevalence of cardiovascular disease (CVD), cardiovascular risk factors (CVRFs), and their control in patients with type 2 diabetes mellitus (T2DM) at primary care settings from the North Catalonia Diabetes Study (NCDS).

DATA SOURCES

In this multicentre cross-sectional descriptive study, data were collected from a random sample of 307 patients with T2DM. The prevalence of CVD, CVRF, metabolic syndrome (MS), coronary heart disease (CHD) risk at 10 years (Framingham Point Scores), and CVRF control was evaluated. MS and lipid profiles were established according to Adult Treatment Panel III criteria.

CONCLUSIONS

CVD prevalence was 22.0% (CHD: 18.9% and peripheral ischemia: 4.5%) and more frequent in men. The prevalence of selected CVRF was: hypertension: 74.5%; dyslipidemia: 77.7%; smoking: 14.9%; obesity 44.9%, and familial CVD: 38.4%. Three or more CVRFs, including T2DM, were observed in 91.3%. MS prevalence was 68.7%. Framingham score was 10.0%, higher in men than in women. CVD prevalence was related to: age, number of CVRFs, duration of diabetes, familial history of CVD, waist circumference, hypertension, lipid profile, kidney disease, and Framingham score, but not to MS by itself. Correct lipid profiles and blood pressure were only observed in 18.9% and 24.0%, respectively, whereas platelet aggregation inhibitors were only recorded in 16.1% of the patient cohort. MS presence was not an independent risk factor of CVD in our study.

IMPLICATIONS FOR PRACTICE

The high prevalence of CVD and an inadequate control of CVRF, which were apparent in the NCDS population, would suggest that advanced practice nurses should consider incorporating specific cardiovascular assessment in their routine care of persons with T2DM.

摘要

目的

本研究旨在评估来自北加泰罗尼亚糖尿病研究(NCDS)的基层医疗环境中2型糖尿病(T2DM)患者的心血管疾病(CVD)患病率、心血管危险因素(CVRFs)及其控制情况。

数据来源

在这项多中心横断面描述性研究中,从307例T2DM患者的随机样本中收集数据。评估了CVD、CVRF、代谢综合征(MS)、10年冠心病(CHD)风险(弗雷明汉评分)和CVRF控制情况。MS和血脂谱根据成人治疗小组III标准确定。

结论

CVD患病率为22.0%(CHD:18.9%,外周缺血:4.5%),男性更为常见。选定的CVRF患病率为:高血压:74.5%;血脂异常:77.7%;吸烟:14.9%;肥胖44.9%,家族性CVD:38.4%。91.3%的患者存在三种或更多CVRF,包括T2DM。MS患病率为68.7%。弗雷明汉评分为10.0%,男性高于女性。CVD患病率与以下因素有关:年龄、CVRF数量、糖尿病病程、CVD家族史、腰围、高血压、血脂谱、肾病和弗雷明汉评分,但与MS本身无关。分别仅在18.9%和24.0%的患者中观察到正确的血脂谱和血压,而血小板聚集抑制剂仅在16.1%的患者队列中记录到。在我们的研究中,MS的存在不是CVD的独立危险因素。

对实践的启示

NCDS人群中明显存在的CVD高患病率以及CVRF控制不足,这表明高级执业护士应考虑在其对T2DM患者的常规护理中纳入特定的心血管评估。

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