Grupo Investigación en Farmacoepidemiología y Farmacovigilancia, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
Rev Panam Salud Publica. 2013 Jun;33(6):383-90.
To determine the effectiveness of lipid-lowering therapy in a sample of patients affiliated with the Sistema General de Seguridad Social en Salud (the Colombian health system).
A cross-sectional study was conducted from 1 January 2010-30 June 2011. From a total of 8 316 patients in 10 cities, a random sample of 600 was stratified according to dyslipidemia. Information on sociodemographic and anthropometric characteristics, risk factors, and pharmacological and laboratory variables were obtained from medical records.
Subjects were predominantly female (56.2%), with a mean age of 65.1 ± 11.5 years; 93.2% had hypertension; 29.0%, diabetes mellitus; and 10.2%, a history of myocardial infarction. The patients were being treated with lovastatin (84.1%) or gemfibrozil (12.3%)-both at doses below what is recommended-or atorvastatin (1.8%). In patients with high cardiovascular risk, 38.6% achieved goals for low-density lipoprotein cholesterol (LDL-C) levels (<100 mg/dL). Among those at moderate risk, 49.4% reached the target level (< 130 mg/dL). On average, there was a 4.9% reduction in LDL-C. Sex, age, history of cardiovascular disease and/or diabetes mellitus, use of hydrochlorothiazide, and poor therapy adherence were statistically associated with a lack of dyslipidemia control.
Because a lack LDL-C control occurred in patients with two or more of the following variables: male, more than 55 years of age, diabetes and/or a history of cardiovascular disease, received lower doses of lovastatin, or non-adherent to treatment, it is recommended that medication be increased based on clearly-defined therapeutic goals and that comorbidities be assessed and effectively treated.
评估降脂治疗在一个隶属于哥伦比亚全民健康系统的患者样本中的效果。
这是一项 2010 年 1 月 1 日至 2011 年 6 月 30 日进行的横断面研究。从 10 个城市的 8316 名患者中，随机抽取 600 名患者进行分层，分层依据为血脂异常。从病历中获取了社会人口学和人体测量学特征、危险因素以及药物治疗和实验室变量的信息。
受试者主要为女性（56.2%），平均年龄为 65.1±11.5 岁；93.2%患有高血压；29.0%患有糖尿病；10.2%有心肌梗死病史。患者接受洛伐他汀（84.1%）或吉非贝齐（12.3%）治疗，两种药物的剂量均低于推荐剂量，或阿托伐他汀（1.8%）治疗。在心血管风险较高的患者中，38.6%的患者达到了低密度脂蛋白胆固醇（LDL-C）水平<100 mg/dL 的目标。在中危风险的患者中，49.4%达到了目标水平<130 mg/dL。平均而言，LDL-C 降低了 4.9%。性别、年龄、心血管疾病和/或糖尿病史、使用氢氯噻嗪以及治疗依从性差与血脂异常控制不佳存在统计学关联。
由于以下变量中至少有两个的患者缺乏 LDL-C 控制：男性、年龄超过 55 岁、患有糖尿病和/或心血管疾病、接受较低剂量的洛伐他汀治疗或不遵医嘱，建议根据明确的治疗目标增加药物剂量，并评估和有效治疗合并症。
