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A victory for statins or a defeat for diet policies? Cholesterol falls in Poland in the past decade: A modeling study.

作者信息

Bandosz Piotr, O'Flaherty Martin, Rutkowski Marcin, Kypridemos Chris, Guzman-Castillo Maria, Gillespie Duncan O S, Solnica Bogdan, Pencina Michael J, Wyrzykowski Bogdan, Capewell Simon, Zdrojewski Tomasz

机构信息

Department of Hypertension and Diabetology, Medical University of Gdansk, ul. Debinki 7, 80-211 Gdansk, Poland; Department of Public Health and Policy, University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, United Kingdom.

Department of Public Health and Policy, University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, United Kingdom.

出版信息

Int J Cardiol. 2015 Apr 15;185:313-9. doi: 10.1016/j.ijcard.2015.03.079. Epub 2015 Mar 10.

DOI:10.1016/j.ijcard.2015.03.079
PMID:25828672
Abstract

AIM

The present study is aimed to examine whether recent changes in population total cholesterol (TC) levels in Poland might be attributed to increased use statins.

METHODS

Two independent, nationally representative cross-sectional studies were conducted in adults aged 18-79 years in 2002 (n=2993, mean age 46.2 years) and 2011 (n=2413, mean age 45.8 years), including measurements of TC in venous blood samples. The mean change of TC between 2002 and 2011 was assessed. Then the expected therapeutic reduction in TC level in 2011 attributable to statins only was calculated based on already published statin effectiveness data. Uncertainty was quantified using probabilistic sensitivity analysis.

RESULTS

Statin uptake in Poland rose to 11.2% in 2011 (95% Confidence Intervals (CI): 10% to 12.5%) and approximately 32% (95% CI: 28.4 to 36.0%) in subjects aged 60-79 years. Mean TC in Poland in 2002 was 5.35 mmol/l, and fell by 0.21 mmol/l (95% CI: 0.14 to 0.28) by 2011. This fall would have been only 0.03 mmol/l (95% CI: -0.04 to 0.10) for the total adult population and 0.06 mmol/l (95% CI: -0.09 to 0.22) in people aged 60-79 years if statins had not been used. Statin use thus apparently explained approximately 85% (95% CI: 49% to 120%) of the observed decrease.

CONCLUSION

Between 2002 and 2011, statin medications apparently explained a large part of the observed fall in population cholesterol level, suggesting very little changes in population TC attributed to dietary changes.

摘要

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