Family physician in Kingston, Ont.
Lead Analyst for the Canadian Primary Care Sentinel Surveillance Network within the Department of Family Medicine at Queen's University in Kingston.
Can Fam Physician. 2024 Mar;70(3):187-196. doi: 10.46747/cfp.7003187.
To estimate the prevalence of dyslipidemia and to describe its management in Canadian primary care.
Retrospective cohort study using primary care electronic medical record data.
Canada.
Adults aged 40 years or older who saw a Canadian Primary Care Sentinel Surveillance Network contributor between January 1, 2018, and December 31, 2019.
Presence or absence of dyslipidemia as identified by a validated case definition and the treatment status of patients identified as having dyslipidemia based on having been prescribed a lipid-lowering agent (LLA).
In total, 50.0% of the 773,081 patients 40 years of age or older who had had a primary care visit in 2018 or 2019 were identified as having dyslipidemia. Dyslipidemia was more prevalent in patients 65 or older (61.5%), in males (56.7%) versus females (44.7%), and in those living in urban areas (50.0%) versus rural areas (45.2%). In patients with documented dyslipidemia, 42.8% had evidence of treatment with an LLA. Stratifying patients by Framingham risk score revealed that those in the high-risk category were more likely to have been prescribed an LLA (65.0%) compared with those in the intermediate-risk group (48.7%) or the low-risk group (22.8%). The strongest determinants of receiving LLA treatment for dyslipidemia include sex, with males being 1.95 times more likely to have been treated compared with females (95% CI 1.91 to 1.98; <.0001); and body mass index, with those with obesity having a significantly increased likelihood of being treated with an LLA (adjusted odds ratio of 1.36, 95% CI 1.32 to 1.41; <.0001).
This study provides an updated look at the prevalence and treatment of dyslipidemia among Canadians. Half of patients aged 40 years or older have dyslipidemia, with an even higher prevalence observed among adults aged 65 years or older, males, and those with obesity or other chronic conditions. There are still gaps in treatment among those with documented dyslipidemia, principally among those calculated to have high or intermediate Framingham risk scores. Particular attention should also be paid to those at higher risk for not receiving treatment, including female patients and those within normal body mass index ranges.
评估加拿大初级保健中血脂异常的流行情况，并描述其管理情况。
使用初级保健电子病历数据的回顾性队列研究。
加拿大。
2018 年 1 月 1 日至 2019 年 12 月 31 日期间在加拿大初级保健监测网络参与者处就诊、年龄在 40 岁或以上的成年人。
采用经过验证的病例定义确定血脂异常的存在或不存在，以及根据开处方使用降脂药物（LLA）确定的血脂异常患者的治疗状况。
在 2018 年或 2019 年接受初级保健就诊的 773081 名 40 岁或以上患者中，有 50.0%被确定为血脂异常。65 岁或以上患者（61.5%）、男性（56.7%）与女性（44.7%）、居住在城市地区（50.0%）与农村地区（45.2%）血脂异常更为常见。在有记录的血脂异常患者中，有 42.8%的患者有接受 LLA 治疗的证据。根据弗雷明汉风险评分对患者进行分层显示，高风险组患者更有可能接受 LLA 治疗（65.0%），而中风险组（48.7%）或低风险组（22.8%）患者则较少接受 LLA 治疗。血脂异常接受 LLA 治疗的最强决定因素包括性别，男性接受治疗的可能性是女性的 1.95 倍（95%CI 1.91 至 1.98；<.0001）；以及体重指数，肥胖患者接受 LLA 治疗的可能性显著增加（调整后比值比为 1.36，95%CI 1.32 至 1.41；<.0001）。
本研究提供了加拿大血脂异常患病率和治疗情况的最新数据。一半的 40 岁或以上患者有血脂异常，65 岁或以上、男性和肥胖或其他慢性疾病患者的患病率更高。在有记录的血脂异常患者中，治疗仍存在差距，主要是在那些Framingham 风险评分高或中危的患者中。还应特别关注那些未接受治疗的风险较高的患者，包括女性患者和体重指数正常范围内的患者。
