Gimeno Ortiz A, Jiménez Romano R, Vázquez Domínguez J A, Rueda Muñoz C
Junta de Extremadura, Consejería de Sanidad y Consumo.
Rev Sanid Hig Publica (Madr). 1993 Jul-Aug;67(4):267-78.
Cardiovascular diseases appear as the first cause of mortality in the Autonomous Community of Extremadura, which represents 48% of all deaths. The rates of hospital morbidity situated them as the 3rd cause of hospital admissions. Because of its part in the production of atherosclerosis and its associations with ischaemic heart disease, the hypercholesterolemia is one of the necessary factors to be controlled in populations, in order to reduce mortality by coronary disease. Therefore, it becomes necessary to know the magnitude and prevalence of serum cholesterol and lipoproteins in our community, for there exist no published data on the matter and as a previous step to the introduction of intervention programmes.
An observational transversal study, stratified by blood pressure and municipalities, in a population of 30 years or more, is carried out. The size of the sample is 1060 persons; out of them 548 persons are hypertensive and 512 normotensive; these are taken as control group. In this populations, analytic tests are made to know the total cholesterol, HDL-cholesterol, LDL-cholesterol and Triglyceride levels. The TEST, the Odds Ratio Calculation, the means comparison (Student T) and means estimation are used in the analysis.
Out of the total sample, 44. 18% show equal or higher than 240 mg/dl cholesterol levels and 53. 96% show higher than 150 mg/dl LDL-C levels; plasmatic triglyceride concentrations higher than 200 mg/dl appear in 10% of the sample. The estimated cholesterol average in the population of Extremadura, older than 30 years, is 202.9 : 252 in normotensive men and 230. 68: 241.1 in hypertensive men. In women, intervals are 230. 5:241:8, and 231.7 [corrected] 248.5 respectively. The association of hypertension with hypercholesterolemia converges in 46.17%, and frequency in normotensive persons is 43.36%; These differences are almost significant. The indicated coexistence represents an important increase of coronary risk. With regard to age, it is directly associated to cholesterolemia and LDL-C values with an Or of 2.47 and 2.41 respectively. On the contrary. Triglyceridemia acts as an independent variable, when studying its relation with age. For sex variable, a statistically significant association with Triglyceride concentration is proved: These concentrations are higher in women with ar Or of 2.64. With regard to cholesterol levels, there exists a predominance in men of less than 45 years, which is surpassed by women in the age group of 45-60 and becomes equal in normotensive populations after this age. No correlation is found between the pathologic antecedents of cardio/cerebrovascular disease and plasmatic cholesterol levels.
The authors opinion is that these important figures in the Autonomous Community, must compel, on the one hand, to study in further depth the main outside or environmental risk factors which have an influence on cholesterolemia an low density lipoproteins levels in the Community of Extremadura and, on the other hand, they must compel to control hypercholesterolemia as well as other risk factors, which contribute negatively to morbid-mortality of cardiovascular diseases.
心血管疾病是埃斯特雷马杜拉自治区的首要死因,占所有死亡人数的48%。医院发病率使其成为住院的第三大原因。由于高胆固醇血症在动脉粥样硬化形成过程中所起的作用及其与缺血性心脏病的关联,它是人群中需要控制的必要因素之一,以降低冠心病死亡率。因此,有必要了解我们社区血清胆固醇和脂蛋白的水平及患病率,因为目前尚无关于此问题的公开数据,且这是引入干预计划的前期步骤。
对30岁及以上人群进行一项观察性横断面研究,按血压和城市分层。样本量为1060人;其中548人为高血压患者,512人为血压正常者,后者作为对照组。对这些人群进行分析测试,以了解总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯水平。分析中使用了检验、比值比计算、均值比较(学生t检验)和均值估计。
在总样本中,44.18%的人胆固醇水平等于或高于240mg/dl,53.96%的人低密度脂蛋白胆固醇水平高于150mg/dl;10%的样本血浆甘油三酯浓度高于200mg/dl。埃斯特雷马杜拉30岁以上人群的估计胆固醇平均水平为202.9:血压正常男性为252,高血压男性为230.68:241.1。女性的区间分别为230.5:241.8和231.7[校正后]:248.5。高血压与高胆固醇血症的关联率为46.17%,血压正常者的频率为43.36%;这些差异几乎具有显著性。所表明的共存情况意味着冠状动脉风险显著增加。关于年龄,它与胆固醇血症和低密度脂蛋白胆固醇值直接相关,比值比分别为2.47和2.41。相反,在研究甘油三酯血症与年龄的关系时,它是一个独立变量。对于性别变量,证明与甘油三酯浓度存在统计学显著关联:女性的这些浓度更高,比值比为2.64。关于胆固醇水平,45岁以下男性占优势,在45 - 60岁年龄组中被女性超过,在此年龄之后在血压正常人群中两者持平。未发现心血管/脑血管疾病的病理史与血浆胆固醇水平之间存在相关性。
作者认为,这些在该自治区的重要数据一方面必须促使人们更深入地研究影响埃斯特雷马杜拉社区胆固醇血症和低密度脂蛋白水平的主要外部或环境风险因素,另一方面必须促使人们控制高胆固醇血症以及其他对心血管疾病的发病死亡率有负面影响的风险因素。