Department of General Practice, School of Public Health. University of Aarhus, Bartholins Allé 2, 8000 Aarhus C, Denmark.
Scand J Prim Health Care. 2010 Mar;28(1):47-54. doi: 10.3109/02813430903335216.
To describe the management of dyslipidaemia in patients with high risk of cardiovascular disease (CVD) and patients with a history of CVD identified by screening for diabetes in general practice in Denmark, concentrating on prescription of lipid-lowering drugs. Moreover, to analyse predicting factors for starting lipid-lowering drugs related to patient and general practice characteristics.
Population-based cross-sectional study with follow-up.
A total of 139 general practices from three of five Danish regions, totalling 216 GPs.
The study population comprised 4986 patients with a high risk of CVD and dyslipidaemia and 764 patients with a history of CVD and dyslipidaemia out of a population of 16 572 patients who completed screening for diabetes but were cleared for diabetes in the ADDITION study.
Of patients with a high risk of CVD and dyslipidaemia not receiving lipid-lowering drugs at the time of screening (n = 4823), 20% started lipid-lowering therapy within the follow-up period (median 2.1 years). This percentage was 45% (n = 536) for patients with CVD and dyslipidaemia (median follow-up period 1.6 years). Age over 50, high cholesterol, impaired fasting glucose and/or impaired glucose tolerance, minor polypharmacy, use of heart/circulation drugs, and cholesterol measurements after screening predicted the prescription of lipid-lowering drugs for patients at high risk of CVD. For patients with CVD, male gender, high cholesterol and use of heart/circulation drugs predicted the prescription of lipid-lowering drugs. No general practice characteristics were associated with different prescription habits.
There is a gap between the recommended lipid-lowering drug therapy and current practice, with a substantial under-treatment and a considerable delay in the first prescription of lipid-lowering drugs.
描述丹麦普通实践中通过糖尿病筛查发现的高心血管疾病（CVD）风险患者和 CVD 病史患者的血脂异常管理，重点关注降脂药物的处方。此外，分析与患者和普通实践特征相关的开始降脂药物的预测因素。
基于人群的横断面研究，随访。
丹麦五个地区中的三个地区的总共 139 个普通实践，共有 216 名全科医生。
该研究人群包括 4986 名高 CVD 和血脂异常风险且正在接受筛查的患者，以及 764 名患有 CVD 和血脂异常病史但在 ADDITION 研究中筛查出无糖尿病的患者。
在筛查时未服用降脂药物的高 CVD 和血脂异常风险患者中（n=4823），20%在随访期间开始降脂治疗（中位时间为 2.1 年）。对于患有 CVD 和血脂异常的患者，这一比例为 45%（n=536）（中位随访时间为 1.6 年）。年龄超过 50 岁、高胆固醇、空腹血糖受损和/或葡萄糖耐量受损、轻度多种药物治疗、使用心脏/循环药物以及筛查后的胆固醇测量值预测了高 CVD 风险患者的降脂药物处方。对于 CVD 患者，男性、高胆固醇和使用心脏/循环药物预测了降脂药物的处方。普通实践特征与不同的处方习惯无关。
推荐的降脂药物治疗与当前实践之间存在差距，存在大量未治疗和降脂药物首次处方的明显延迟。
