Siggaard-Andersen Niels, Freiberg Jacob J, Nordestgaard Børge G
Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, Herlev Ringvej 75, Herlev, Denmark.
Dan Med J. 2012 Jul;59(7):A4470.
We tested the hypothesis that individuals in the general population with and without ischaemic cardiovascular disease, or with diabetes, are treated to recommended target values for plasma lipids.
We used the Copenhagen General Population Study in which 69,354 individuals were examined cross-sectionally from 2004 through 2010. Among this population, 1,521 had previously had myocardial infarction, 2,372 other ischaemic heart disease, 542 ischaemic stroke, 2,086 claudicatio intermittens and 2,155 had diabetes.
The fraction of participants using lipid-lowering therapy among those with myocardial infarction was 70%, other ischaemic heart disease 44%, ischaemic stroke 60%, claudicatio intermittens 33%, diabetes 48%, and for those without ischaemic cardiovascular disease 8%. Among those with myocardial infarction with and without lipid-lowering therapy, 41% and 84%, respectively, had not reached a total cholesterol < 4.5 mmol/l, 30% and 79%, respectively, had not reached a low-density lipoprotein cholesterol < 2.5 mmol/l, and 46% and 48%, respectively, had not reached triglycerides < 1.7 mmol/l. In those with other ischaemic cardiovascular disease, with diabetes or without ischaemic cardiovascular disease, a similar or larger fraction of individuals did not reach guideline lipid targets.
Large fractions of individuals with ischaemic cardiovascular disease or diabetes are not treated with lipid-lowering therapy. Even among many of those treated, plasma total cholesterol, low-density lipoprotein cholesterol and triglycerides are not treated to guideline targets.
我们检验了这样一个假设,即普通人群中患有和未患有缺血性心血管疾病或患有糖尿病的个体,其血脂是否被治疗至推荐的目标值。
我们采用了哥本哈根普通人群研究,该研究在2004年至2010年期间对69354名个体进行了横断面检查。在这一人群中,1521人曾患心肌梗死,2372人患有其他缺血性心脏病,542人患有缺血性中风,2086人患有间歇性跛行,2155人患有糖尿病。
心肌梗死患者中使用降脂治疗的比例为70%,其他缺血性心脏病患者为44%,缺血性中风患者为60%,间歇性跛行患者为33%,糖尿病患者为48%,而无缺血性心血管疾病的患者为8%。在接受和未接受降脂治疗的心肌梗死患者中,分别有41%和84%的患者总胆固醇未达到<4.5 mmol/l,分别有30%和79%的患者低密度脂蛋白胆固醇未达到<2.5 mmol/l,分别有46%和48%的患者甘油三酯未达到<1.7 mmol/l。在患有其他缺血性心血管疾病、糖尿病或无缺血性心血管疾病的患者中,未达到血脂指南目标的个体比例相似或更高。
很大一部分患有缺血性心血管疾病或糖尿病的个体未接受降脂治疗。即使在许多接受治疗的患者中,血浆总胆固醇、低密度脂蛋白胆固醇和甘油三酯也未达到指南目标。