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澳大利亚农村的血脂异常:大绿三角风险因素研究中的患病率、知晓率和治疗指南依从性。

Dyslipidaemia in rural Australia: prevalence, awareness, and adherence to treatment guidelines in the Greater Green Triangle Risk Factor Study.

机构信息

Greater Green Triangle University Department of Rural Health, Flinders University and Deakin University, Warrnambool, VIC.

出版信息

Med J Aust. 2010 Feb 1;192(3):127-32. doi: 10.5694/j.1326-5377.2010.tb03449.x.

Abstract

OBJECTIVES

To determine population lipid profiles, awareness of hyperlipidaemia and adherence to Australian lipid management guidelines.

DESIGN AND SETTING

Population survey in rural south-eastern Australia, 2004-2006.

PARTICIPANTS

Stratified random sample from the electoral roll. Data from 1274 participants (40%) aged 25-74 years were analysed.

MAIN OUTCOME MEASURES

Population mean total, low-density lipoprotein and high-density lipoprotein cholesterol (TC, LDL-C and HDL-C) and triglyceride (TG) concentrations, prevalence of dyslipidaemia, and treatment according to 2001 and 2005 Australian guideline target levels.

RESULTS

Population-adjusted mean TC, TG, LDL-C and HDL-C concentrations were 5.38 mmol/L (95% CI, 5.30-5.45), 1.50 mmol/L (95% CI, 1.43-1.56), 3.23 mmol/L (95% CI, 3.16-3.30) and 1.46 mmol/L (95% CI, 1.44-1.49), respectively. Prevalence of hypercholesterolaemia (TC > 5.5 mmol/L or on treatment) was 48%. Lipid-lowering medication use was reported by 12%. Seventy-seven of 183 participants with established cardiovascular disease (CVD) or diabetes were untreated, and of the 106 treated, 59% reached the target LDL-C. Of those without CVD or diabetes already treated, 38% reached target LDL-C, and 397 participants at high absolute risk did not receive primary prevention. Ninety-five per cent of treated individuals with CVD or diabetes and 86% of others treated had cholesterol measured in the previous year. Sixty-nine per cent of individuals at low risk aged over 45 years had their cholesterol measured within the previous 5 years.

CONCLUSIONS

A comprehensive national strategy for lowering mean population cholesterol is required, as is better implementation of absolute risk management guidelines - particularly in rural populations.

摘要

目的

确定人群的血脂水平、对高脂血症的认知程度以及对澳大利亚血脂管理指南的遵循情况。

设计和设置

2004-2006 年在澳大利亚东南部农村进行的人群调查。

参与者

从选民名单中抽取分层随机样本。分析了 1274 名年龄在 25-74 岁的参与者(40%)的数据。

主要观察指标

人群平均总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)及三酰甘油(TG)浓度、血脂异常的患病率以及根据 2001 年和 2005 年澳大利亚指南目标水平进行的治疗情况。

结果

人群校正后的平均 TC、TG、LDL-C 和 HDL-C 浓度分别为 5.38mmol/L(95%可信区间,5.30-5.45)、1.50mmol/L(95%可信区间,1.43-1.56)、3.23mmol/L(95%可信区间,3.16-3.30)和 1.46mmol/L(95%可信区间,1.44-1.49)。高胆固醇血症(TC>5.5mmol/L 或正在治疗)的患病率为 48%。报告使用降脂药物的有 12%。183 例已有心血管疾病(CVD)或糖尿病的患者中,77 例未接受治疗,106 例接受治疗的患者中,59%达到 LDL-C 目标值。已经接受治疗的 CVD 或糖尿病患者中,38%达到 LDL-C 目标值,而 397 名高绝对风险的患者未接受一级预防。95%的 CVD 或糖尿病患者中接受治疗者和 86%的其他患者中接受治疗者,其胆固醇在过去一年中得到了检测。69%的低危年龄超过 45 岁者在过去 5 年内进行过胆固醇检测。

结论

需要制定降低人群平均胆固醇水平的综合国家战略,还需要更好地执行绝对风险管理指南——特别是在农村地区。

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