缺血性心脏病患者中未诊断出的心血管危险因素,包括脂蛋白(a)升高。
Undiagnosed cardiovascular risk factors including elevated lipoprotein(a) in patients with ischaemic heart disease.
作者信息
Chua Fionn, Lam Audrey, Mak Ying Hui, Lee Zhong Hui, Dacay Lily Mae, Yew Jie Lin, Puar Troy, Khoo Joan, Chow Weien, Tan Vern Hsen, Tong Khim Leng, Liew Boon Wah, Yeo Colin, Loh Wann Jia
机构信息
Dietetics Department, Changi General Hospital, Singapore, Singapore.
Department of Pharmacy, Changi General Hospital, Singapore, Singapore.
出版信息
Front Epidemiol. 2023 Jul 17;3:1207752. doi: 10.3389/fepid.2023.1207752. eCollection 2023.
OBJECTIVES
This study aims to investigate the prevalence of undiagnosed cardiovascular risk factors in patients with ischaemic heart disease (IHD).
METHODS
We assessed the prevalence of previously undiagnosed cardiovascular risk factors, including elevated lipoprotein(a) [Lp(a)], among consenting patients with IHD who were admitted to hospital. Clinical information, including dietary history, from patients with newly diagnosed IHD and known IHD were compared.
RESULTS
Of the 555 patients, 82.3% were males and 48.5% of Chinese ethnicity. Overall, 13.3% were newly diagnosed with hypertension, 14.8% with hypercholesterolemia, and 5% with type 2 diabetes (T2DM). Patients with newly diagnosed IHD, compared to those with known IHD, had a higher prevalence of new diagnoses of hypercholesterolemia (29.1% vs. 2.0%, < 0.001), hypertension (24.5% vs. 3.4%, < 0.001) and T2DM (7.3% vs. 3.1%, = 0.023). Active smoking was prevalent in 28.3% of patients, and higher in newly diagnosed IHD (34.1% vs. 23.2%, = 0.005). Elevated Lp(a) of ≥120 nmol/L was detected in 15.6% of all patients, none of whom were previously diagnosed. Dietary habits of >50% of patients in both groups did not meet national recommendations for fruits, vegetables, wholegrain and oily fish intake. However, patients with known IHD had a more regular omega-3 supplement intake (23.4% vs. 10.3%, = 0.024).
CONCLUSION
Increased detection efforts is necessary to diagnose chronic metabolic diseases (hypertension, hypercholesterolemia, T2DM) especially among patients at high risk for IHD. Cardiovascular risk factors, in particular elevated Lp(a), smoking, and suboptimal dietary intake in patients with IHD deserve further attention.
目的
本研究旨在调查缺血性心脏病(IHD)患者中未诊断出的心血管危险因素的患病率。
方法
我们评估了入院的IHD患者中先前未诊断出的心血管危险因素的患病率,包括脂蛋白(a)[Lp(a)]升高。比较了新诊断的IHD患者和已知IHD患者的临床信息,包括饮食史。
结果
555例患者中,82.3%为男性,48.5%为华裔。总体而言,13.3%的患者新诊断为高血压,14.8%的患者新诊断为高胆固醇血症,5%的患者新诊断为2型糖尿病(T2DM)。与已知IHD患者相比,新诊断的IHD患者新诊断为高胆固醇血症(29.1%对2.0%,P<0.001)、高血压(24.5%对3.4%,P<0.001)和T2DM(7.3%对3.1%,P=0.023)的患病率更高。28.3%的患者有主动吸烟史,新诊断的IHD患者中吸烟率更高(34.1%对23.2%,P=0.005)。所有患者中有15.6%检测到Lp(a)≥120 nmol/L,且之前均未被诊断出。两组中超过50%的患者饮食习惯未达到国家对水果、蔬菜、全谷物和油性鱼类摄入量的建议。然而,已知IHD的患者ω-3补充剂摄入更规律(23.4%对10.3%,P=0.024)。
结论
有必要加大检测力度以诊断慢性代谢性疾病(高血压、高胆固醇血症、T2DM),尤其是在IHD高危患者中。IHD患者的心血管危险因素,特别是Lp(a)升高、吸烟和饮食摄入不理想值得进一步关注。
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