Párraga Martínez Ignacio, Campo Del Campo José María Del, Muñoz Sánchez-Villacañas Rafael, Villena Ferrer Alejandro, Morena Rayo Susana, González Felipe Natividad, López-Torres Hidalgo Jesús
Unidad de Investigación, Gerencia de Atención Primaria de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España.
Rev Esp Salud Publica. 2011 Jun;85(3):305-13. doi: 10.1590/S1135-57272011000300009.
For a proper approach to the subjects, in which the presence of hypercholesterolemia is identified for the first time, is important to consider simultaneously both cardiovascular risk factors and the presence of other diseases. The purpose of our study was to describe the lipid profile of patients in which the presence of hypercholesterolemia is detected for the frist time and to determine their cardiovascular risk and comorbidity.
Observational cross-sectional study in a Primary Care setting. In 274 subjects with a plasma cholesterol level higher or equal to 200 mg / dL ("limit" hypercholesterolemia), selected by consecutive sampling, we assessed: lipid profile, cardiovascular risk factors and cardiovascular risk (SCORE and Castelli's atherogenic index), comorbidity (Charlson's Index) and sociodemographic characteristics.
The mean cholesterol level was 232.9 mg/dl. Hypercholesterolaemia was reported "definite" (>= 250 mg / dl) in 21.1% (95% CI: 16.2 to 26.1). A 9.5% showed a cardiovascular risk >= 5%. Lipoprotein ratio of total cholesterol/HDL cholesterol was higher in men than in women (4.4 vs. 3.8, p <0.001) in subjects with Charlson's Comorbidity Index > = 1 (4.1 vs. 3.9, p = 0.04), in smokers (4.3 vs. 3.9, p = 0.04) and in hypertensive subjects (4.2 vs. 3.9, p = 0.03), obese (4.2 vs 3 , 7, p <0.05) or with the metabolic syndrome (4.4 vs 3.9, p = 0.02). We observed a higher proportion of subjects with moderate cardiovascular risk / high or cardiovascular disease in those with comorbidity (87.3% vs 42.3%, p <0.01).
More than a third of the subjects in which "limit" cholesterol was identifiyed for the first time presents comorbidity, being "defined" hypercholesterolemia in 21.1% of the cases. Takeing in consideration the Score function assessment, one outif 10 subjects presents high cardiovascular mortality risk after 10 years. Both lipoprotein ratio and cardiovascular risk are markedly higher in subjects with comorbidity.
对于首次确诊为高胆固醇血症的患者，恰当的处理方法是同时考虑心血管危险因素和其他疾病的存在情况。我们研究的目的是描述首次检测出高胆固醇血症患者的血脂谱，并确定他们的心血管风险和合并症情况。
在初级保健机构中进行观察性横断面研究。通过连续抽样选取274名血浆胆固醇水平高于或等于200mg/dL（“临界”高胆固醇血症）的受试者，我们评估了：血脂谱、心血管危险因素和心血管风险（SCORE和卡斯泰利动脉粥样硬化指数）、合并症（查尔森指数）以及社会人口学特征。
平均胆固醇水平为232.9mg/dl。21.1%（95%可信区间：16.2%至26.1%）的患者被报告为“确诊”高胆固醇血症（≥250mg/dl）。9.5%的患者心血管风险≥5%。在查尔森合并症指数≥1的受试者中（4.1对3.9，p = 0.04）、吸烟者中（4.3对3.9，p = 0.04）、高血压患者中（4.2对3.9，p = 0.03）、肥胖者中（4.2对3.7，p <0.05）或患有代谢综合征的患者中（4.4对3.9，p = 0.02），男性的总胆固醇/高密度脂蛋白胆固醇脂蛋白比率高于女性（4.4对3.8，p <0.001）。我们观察到合并症患者中具有中度心血管风险/高风险或患有心血管疾病的受试者比例更高（87.3%对42.3%，p <0.01）。
首次确诊为“临界”胆固醇水平的患者中，超过三分之一患有合并症，21.1%的病例为“确诊”高胆固醇血症。考虑到Score函数评估，每10名受试者中有1名在10年后具有较高的心血管死亡风险。合并症患者的脂蛋白比率和心血管风险均明显更高。
