Marques-Vidal Pedro, Chekanova Valeriya, de Mestral Carlos, Guessous Idris, Stringhini Silvia
Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
National Medical Research Center of Cardiology, Moscow, Russia.
Int J Cardiol Cardiovasc Risk Prev. 2023 May 19;18:200187. doi: 10.1016/j.ijcrp.2023.200187. eCollection 2023 Sep.
We assessed 1) trends in prevalence, awareness, treatment and control rates of dyslipidaemia and associated factors, 2) the effect of statin generation/potency on control levels and 3) the effect of ESC lipid guidelines, on lipid management. Data from multiple cross-sectional, population-based surveys conducted between 2005 and 2019 in the canton of Geneva, Switzerland, were used. Prevalence, awareness, treatment and control rates of dyslipidaemia were 46.0% and 34.9% (p < 0.001), 67.0% and 77.3% (p = 0.124), 40.0% and 19.9% (p < 0.001), and 68.0% and 84.0% (p = 0.255), in 2005 and 2019, respectively. After multivariable adjustment, only the decrease in treatment rates was significant. Increasing age, higher BMI, history of hypertension or diabetes were positively associated with prevalence, while female sex was negatively associated. Female sex, history of diabetes or CVD were positively associated with awareness, while increasing age was negatively associated. Increasing age, smoking, higher BMI, history of hypertension, diabetes or CVD were positively associated with treatment, while female sex was negatively associated. Female sex was positively associated with control, while increasing age was negatively associated. Highly potent statins increased from 50.0% to 87.5% and third generation statins from 0% to 47.5% in 2009 and 2015, respectively. Increased statin potency was borderline (p = 0.059) associated with dyslipidaemia control. ESC guidelines had no effect regarding the prescription of more potent or higher generation statins. We conclude that in the canton of Geneva, treatment of diagnosed dyslipidaemia is low, but control is adequate. Women are undertreated but better controlled than men. The most potent hypolipidemic drugs are underused.
1)血脂异常的患病率、知晓率、治疗率和控制率趋势及其相关因素;2)他汀类药物代数/效力对控制水平的影响;3)欧洲心脏病学会(ESC)血脂指南对血脂管理的影响。我们使用了2005年至2019年期间在瑞士日内瓦州进行的多项基于人群的横断面调查数据。2005年和2019年血脂异常的患病率、知晓率、治疗率和控制率分别为46.0%和34.9%(p<0.001)、67.0%和77.3%(p = 0.124)、40.0%和19.9%(p<0.001)以及68.0%和84.0%(p = 0.255)。多变量调整后,只有治疗率的下降具有统计学意义。年龄增加、体重指数(BMI)较高、有高血压或糖尿病病史与患病率呈正相关,而女性与患病率呈负相关。女性、有糖尿病或心血管疾病(CVD)病史与知晓率呈正相关,而年龄增加与知晓率呈负相关。年龄增加、吸烟、BMI较高、有高血压、糖尿病或CVD病史与治疗率呈正相关,而女性与治疗率呈负相关。女性与控制率呈正相关,而年龄增加与控制率呈负相关。2009年和2015年,高效能他汀类药物的使用比例分别从50.0%增至87.5%,第三代他汀类药物从0%增至47.5%。他汀类药物效力的增加与血脂异常控制的相关性接近临界值(p = 0.059)。ESC指南对更高效能或更高代数他汀类药物的处方没有影响。我们得出结论,在日内瓦州,已诊断血脂异常的治疗率较低,但控制情况良好。女性治疗不足,但比男性控制得更好。最有效的降血脂药物未得到充分使用。