Vilaseca Canais J, Buxeda Mestres C, Cámara Contreras C, Flor Serra F, Pérez Guinaldo R, Sánchez Viñas M
Unidad Docente de MFyC, ABS Sant Josep, CAP Just Oliveras L' Hospitalet de Llobregat, Barcelona.
Aten Primaria. 1997 Jun 15;20(1):49-53.
To study the appropriateness of lipid-lowering drugs treatment through four methods of calculating coronary risk (CR).
Crossover study.
Primary care centre.
All patients receiving lipid-lowering drugs.
CR was determined for individuals with application criteria by four methods: the simplified Framingham, Dundee-Risk-Disk, modified Sheffield label and Cardiovascular Risk in Primary Care (CVRap). 330 patients followed the treatment, 137 men and 193 women with an average age of 58.8 (SD 10.2). 54.2% received statims, 28.5% clofibrates, 13.6% resins and 3.6% other drugs. 186 patients were included, 75 (22.7%) being excluded because of secondary prevention and the rest because they were not the right age or had no cholesterol data prior to treatment. 38.3% were at high CR according to Framingham, 25.6% according to CVRap, 18.7% according to Dundee-Risk-Disk and 16% according to modified Sheffield. Concordance between these methods was adequate.
Between 16% and 38.3% of the individuals treated are at high CR. If we also include patients with severe Hypercholesterolaemia and diabetics with Hypercholesterolaemia, this percentage rises to 59.7-73.3%, according to the CR assessment method used.
通过四种计算冠心病风险(CR)的方法研究降脂药物治疗的适宜性。
交叉研究。
基层医疗中心。
所有接受降脂药物治疗的患者。
采用四种方法对符合应用标准的个体确定CR:简化的弗明汉姆法、邓迪风险盘法、改良的谢菲尔德标签法和基层医疗心血管风险(CVRap)法。330例患者接受了治疗,其中137例男性和193例女性,平均年龄58.8岁(标准差10.2)。54.2%的患者接受他汀类药物治疗,28.5%接受氯贝丁酯治疗,13.6%接受树脂类药物治疗,3.6%接受其他药物治疗。纳入186例患者,75例(22.7%)因二级预防被排除,其余患者因年龄不符或治疗前无胆固醇数据被排除。根据弗明汉姆法,38.3%的患者冠心病风险高;根据CVRap法为25.6%;根据邓迪风险盘法为18.7%;根据改良的谢菲尔德法为16%。这些方法之间的一致性良好。
接受治疗的个体中,16%至38.3%的患者冠心病风险高。如果将严重高胆固醇血症患者和伴有高胆固醇血症的糖尿病患者也包括在内,根据所使用的冠心病风险评估方法,这一比例将升至59.7% - 73.3%。