Temelkova-Kurktschiev Theodora S, Kurktschiev Dimo P, Vladimirova-Kitova Lyudmila G, Vaklinova I, Todorova Boryana R
Medicobiological Centre, International Scientific Institute, National Sports University, Sofia, Bulgaria.
Folia Med (Plovdiv). 2009 Apr-Jun;51(2):26-32.
Hypercholesterolaemia, hypertriglyceridaemia and low high-density lipoprotein (HDL) cholesterol are established risk factors of macrovascular disease, which leads to stroke and myocardial infarction and is the leading cause of death in Bulgaria. The AIM of our study was to examine the prevalence and type of hyper/dyslipidaemia in patients with myocardial infarction, hypertension and type 2 diabetes mellitus in Bulgaria.
A total of 1230 subjects were examined who had positive own and family history of acute myocardial infarction (AMI) (n=365), hypertension (n=250), type 2 diabetes mellitus (n=250), or neither of the diseases, healthy controls (n=365). All participants filled a questionnaire on medical history, current medication, lifestyle and family history. They underwent standardised measurements of anthropometric parameters and blood pressure. Venous blood was drawn after an overnight fast to test for atherosclerosis risk factors such as lipids, glucose, etc.
Although younger than the controls the patients with history of AMI, hypertension and type 2 diabetes had a significantly higher body mass index and waist circumference, as well as significantly higher blood pressure. Seventy percent of the AMI patients received lipid lowering treatment. Total cholesterol level was higher in all patients groups than that in controls, the difference being statistically significant for the AMI patients. Triglycerides were significantly higher in the AMI and the diabetic group in comparison with the controls. HDL cholesterol was lower in all patients groups than that in the controls, the difference being significant between the controls and patients with history ofAMI and diabetes. Hypercholesterolemia was observed in 69.6% of the AMI patients, 51% of the hypertensive patients, 56% of the diabetics and 36% of the controls; triglycerides level above 1.7 mmol/l was found in 85% of the AMI subjects, 28% of the hypertensive patients, 36% of the diabetic patients and 14% of the controls; and low HDL cholesterol--in 61% of the AMI patients, 21% of the hypertensive patients, 28% of the diabetics and 16% of the controls.
Our study demonstrates that hypercholesterolemia, hypertriglyceridemia and low HDL cholesterol are very common in patients with history of myocardial infarction, hypertension and type 2 diabetes in Bulgaria and that treatment of the main cardiovascular risk factors seems to be insufficient in these patients.
高胆固醇血症、高甘油三酯血症和低高密度脂蛋白（HDL）胆固醇是已确定的大血管疾病风险因素，大血管疾病可导致中风和心肌梗死，是保加利亚的主要死因。我们研究的目的是调查保加利亚心肌梗死、高血压和2型糖尿病患者中高/血脂异常的患病率和类型。
共检查了1230名受试者，他们有急性心肌梗死（AMI）（n = 365）、高血压（n = 250）、2型糖尿病（n = 250）的个人或家族病史，或无这些疾病，为健康对照组（n = 365）。所有参与者填写了关于病史、当前用药、生活方式和家族病史的问卷。他们接受了人体测量参数和血压的标准化测量。过夜禁食后抽取静脉血，以检测动脉粥样硬化风险因素，如血脂、血糖等。
虽然有AMI、高血压和2型糖尿病病史的患者比对照组年轻，但他们的体重指数和腰围明显更高，血压也明显更高。70%的AMI患者接受了降脂治疗。所有患者组的总胆固醇水平均高于对照组，AMI患者的差异具有统计学意义。与对照组相比，AMI组和糖尿病组的甘油三酯明显更高。所有患者组的HDL胆固醇均低于对照组，对照组与有AMI和糖尿病病史的患者之间的差异显著。69.6%的AMI患者、51%的高血压患者、56%的糖尿病患者和36%的对照组出现高胆固醇血症；85%的AMI受试者、28%的高血压患者、36%的糖尿病患者和14%的对照组甘油三酯水平高于1.7 mmol/l；61%的AMI患者、21%的高血压患者、28%的糖尿病患者和16%的对照组出现低HDL胆固醇。
我们的研究表明，在保加利亚，有心肌梗死、高血压和2型糖尿病病史的患者中，高胆固醇血症、高甘油三酯血症和低HDL胆固醇非常常见，而且这些患者主要心血管风险因素的治疗似乎不足。
