University of Cape Town, Cape Town, South Africa.
Heart Institute (InCor), University of Sao Paulo Medical School Hospital and Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Eur J Prev Cardiol. 2020 Sep;27(13):1403-1411. doi: 10.1177/2047487319871735. Epub 2019 Sep 19.
Comprehensive control of multiple cardiovascular risk factors reduces cardiovascular risk but is difficult to achieve.
A multinational, cross-sectional, observational study.
The International ChoLesterol management Practice Study (ICLPS) investigated achievement of European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline low-density lipoprotein cholesterol (LDL-C) targets in patients receiving lipid-modifying therapy in countries outside Western Europe. We examined the rate of, and association between, control of multiple risk factors in ICLPS participants with dyslipidaemia, diabetes and hypertension (N = 2377).
Mean (standard deviation) age of patients was 61.4 (10.4) years; 51.3% were male. Type 2 diabetes was the most common form of diabetes (prevalence, 96.9%). The prevalence of metabolic syndrome was 67.8%, obesity 40.4%, atherosclerotic disease 39.6% and coronary artery disease 33.5%. All patients were at high (38.2%) or very high (61.8%) cardiovascular risk according to ESC/EAS guidelines. Body mass index (BMI) was <25 kg/m in 20.3% of patients, 62.8% had never smoked and 25.2% were former smokers. Overall, 12.2% achieved simultaneous control of LDL-C, diabetes and blood pressure. Risk factor control was similar across all participating countries. The proportion of patients achieving individual guideline-specified treatment targets was 43.9% for LDL-C, 55.5% for blood pressure and 39.3% for diabetes. Multiple correspondence analysis indicated that control of LDL-C, control of blood pressure, control of diabetes, BMI and smoking were associated.
Comprehensive control of multiple cardiovascular risk factors in high-risk patients is suboptimal worldwide. Failure to control one risk factor is associated with poor control of other risk factors.
综合控制多种心血管危险因素可降低心血管风险，但难以实现。
一项多国家、跨地区、观察性研究。
国际胆固醇管理实践研究（ICLPS）调查了在西欧以外国家接受降脂治疗的患者中，欧洲心脏病学会（ESC）/欧洲动脉粥样硬化学会（EAS）指南低密度脂蛋白胆固醇（LDL-C）目标的达标情况。我们检查了患有血脂异常、糖尿病和高血压的 ICLPS 参与者中，多种危险因素控制的比率和相关性（N=2377）。
患者的平均（标准差）年龄为 61.4（10.4）岁；51.3%为男性。2 型糖尿病是最常见的糖尿病类型（患病率为 96.9%）。代谢综合征的患病率为 67.8%，肥胖症为 40.4%，动脉粥样硬化疾病为 39.6%，冠心病为 33.5%。根据 ESC/EAS 指南，所有患者均处于高（38.2%）或极高（61.8%）心血管风险状态。20.3%的患者体重指数（BMI）<25kg/m2，62.8%从未吸烟，25.2%为曾经吸烟者。总体而言，12.2%的患者同时实现了 LDL-C、糖尿病和血压的控制。所有参与国家的危险因素控制情况相似。达到 LDL-C、血压和糖尿病个别指南规定的治疗目标的患者比例分别为 43.9%、55.5%和 39.3%。多元对应分析表明，LDL-C 的控制、血压的控制、糖尿病的控制、BMI 和吸烟与危险因素的控制有关。
在全球范围内，高危患者对多种心血管危险因素的综合控制并不理想。一种危险因素控制不佳与其他危险因素控制不佳相关。
