Boumendil E F
INSERM, Unit 88, Paris, France.
J Clin Epidemiol. 1994 Oct;47(10):1163-71. doi: 10.1016/0895-4356(94)90102-3.
The objectives of this cross-sectional study presented as the first stage of a cohort follow-up pharmacoepidemiological study of lipid modulators, are to determine the extent and pattern of use of antihyperlipidemics and concomitant drugs and to compare antihyperlipidemic subgroups. The study population are the 17,244 respondents to the 1991 questionnaire in which questions on drug utilization were asked for the first time. It comprises 40.5% of the men and 32% of the women of the population originally targeted in 1989, i.e. the entire workforce of a national company within an age range of 35-45 years for men and 35-50 years for women. Self-reported health events and drug use over the previous year were measured. Overall 1 year prevalence of use of lipid lowering drugs was 7.7% (9.5% in men and 2.7% in women). Most antihyperlipidemics were fibrates (n = 878), with fenofibrate ranking above ciprofibrate, as opposed to HMG-CoA reductase inhibitors (n = 436), principally simvastatin. Only 60% of antihyperlipidemic drug users were following a prescribed lipid-lowering diet; over half were taking other drugs concomitantly, most often b-blockers. The simvastatin group differs from the fibrate group by an excess of prevalent thyroid disease. The link between simvastatin and thyroid disease may be indication-related. In conclusion, the relevant features of this study are the extensive use of antihyperlipidemics, frequently, without concomitant diet, and the marked preference for antihyperlipidemics for which long term safety is unknown. Extent of use and choices of antihyperlipidemics are corroborated by estimations in the general middle-aged population.
本横断面研究作为脂质调节剂队列随访药物流行病学研究的第一阶段,其目的是确定抗高脂血症药物及伴随用药的使用范围和模式,并比较抗高脂血症亚组。研究人群为1991年调查问卷的17244名受访者,该问卷首次询问了药物使用问题。它占1989年最初目标人群中男性的40.5%和女性的32%,即一家全国性公司年龄在35至45岁的男性和35至50岁的女性的全体员工。测量了过去一年自我报告的健康事件和药物使用情况。总体而言,降脂药物的1年使用率为7.7%(男性为9.5%,女性为2.7%)。大多数抗高脂血症药物为贝特类(n = 878),非诺贝特排名高于环丙贝特,而HMG-CoA还原酶抑制剂(n = 436)主要是辛伐他汀。只有60%的抗高脂血症药物使用者遵循规定的降脂饮食;超过一半的人同时服用其他药物,最常见的是β受体阻滞剂。辛伐他汀组与贝特类组的区别在于甲状腺疾病患病率较高。辛伐他汀与甲状腺疾病之间的联系可能与适应症有关。总之,本研究的相关特点是抗高脂血症药物的广泛使用,且常常没有伴随饮食,以及对长期安全性未知的抗高脂血症药物有明显偏好。抗高脂血症药物的使用范围和选择在一般中年人群的估计中得到了证实。