Díaz Rodríguez Ángel, Blasco Valle Mariano, Mantilla Morató Teresa, Capón Alvarez Jessica, Rodríguez de Miguel Marta, Rodríguez-Fortúnez Patricia, Prada-Marcos Cristina, Orera-Peña María Luisa
Primary Care Center Bembibre, Universidad de León, León, Spain.
Primary Care Center Delicias, Zaragoza, Spain.
Clin Investig Arterioscler. 2019 Sep-Oct;31(5):203-209. doi: 10.1016/j.arteri.2019.03.001. Epub 2019 Jul 15.
To describe the management of atherogenic dyslipidemia (AD) in routine clinical practice in the Primary Care (PC) setting in Spain.
Observational, descriptive, cross-sectional study based on a structured questionnaire designed for this study and addressed to PC physicians. The questionnaire content was based on a literature review and was validated by 3 experts in AD.
A total of 1029 PC physicians participated in the study. 96.99% indicated that AD is determinant for cardiovascular risk, even if LDL-C levels are appropriate. 88.43% evaluated residual cardiovascular risk in their clinical practice, however, only 27.89% of them evaluated it in secondary prevention. Regarding diagnosis, 82.22% reported that TC, TG, HDL-C and non-HDL-C are essential measures when evaluating AD. Almost all physicians reported that they can request fractionated cholesterol to assess HDL-C and LDL-C, however 3.69% could not. Physicians (95.63%) considered that the first step in AD treatment should be diet, regular exercise, smoking cessation and pharmaceutical treatment, if necessary. 19.1% agreed partially or completely that gemfibrozil is the most suitable fibrate to associate with statins. 74.83% completely agreed that fenofibrate is the most suitable fibrate to combine with statins.
Physicians have access to general Spanish guidelines and recommendations associated with AD management, however, it is necessary to continue rising awareness about the importance of early detection and optimal control of AD to reduce patients' cardiovascular risk.
描述西班牙初级保健（PC）环境下常规临床实践中动脉粥样硬化性血脂异常（AD）的管理情况。
基于为本研究设计的结构化问卷进行观察性、描述性横断面研究，该问卷面向PC医生。问卷内容基于文献综述，并经3位AD专家验证。
共有1029名PC医生参与了该研究。96.99%的医生表示，即使低密度脂蛋白胆固醇（LDL-C）水平正常，AD仍是心血管风险的决定因素。88.43%的医生在临床实践中评估残余心血管风险，然而，其中只有27.89%的医生在二级预防中进行评估。关于诊断，82.22%的医生报告说，在评估AD时，总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）和非高密度脂蛋白胆固醇（non-HDL-C）是必不可少的指标。几乎所有医生都报告说他们可以要求检测胆固醇组分以评估HDL-C和LDL-C，然而3.69%的医生无法做到。95.63%的医生认为AD治疗的第一步应该是饮食、规律运动、戒烟以及必要时的药物治疗。19.1%的医生部分或完全同意吉非贝齐是与他汀类药物联合使用最合适的贝特类药物。74.83%的医生完全同意非诺贝特是与他汀类药物联合使用最合适的贝特类药物。
医生可以获取与AD管理相关的西班牙通用指南和建议，然而，有必要继续提高对AD早期检测和最佳控制以降低患者心血管风险重要性的认识。
