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[Comorbidity and cardiovascular risk in subjects with initial diagnosis of hypercholesterolemia]
Ignacio Párraga Martínez1, José María Del Campo Del Campo, Rafael Muñoz Sánchez-Villacañas
1Unidad de Investigación, Gerencia de Atención Primaria de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España. iparraga@sescam.jccm.es
Insights
Newly diagnosed hypercholesterolemia patients often have comorbidities, increasing cardiovascular risk. Early assessment of lipid profiles, risk factors, and comorbidities is crucial for effective management.
Area of Science:
- Cardiology
- Primary Care Medicine
- Public Health
Background:
- Hypercholesterolemia management requires considering co-existing conditions and cardiovascular risk factors.
- Early identification of hypercholesterolemia necessitates a comprehensive patient assessment.
Purpose of the Study:
- To characterize the lipid profile of newly diagnosed hypercholesterolemia patients.
- To determine the cardiovascular risk and comorbidity burden in this population.
Main Methods:
- An observational, cross-sectional study was conducted in a primary care setting.
- 274 patients with cholesterol ≥ 200 mg/dL were analyzed for lipid profile, cardiovascular risk (SCORE, Castelli's index), and comorbidity (Charlson's Index).
Main Results:
- Mean cholesterol was 232.9 mg/dL, with 21.1% having definite hypercholesterolemia (≥ 250 mg/dL).
- 9.5% had a cardiovascular risk ≥ 5%. The total cholesterol/HDL cholesterol ratio was higher in men, smokers, and those with comorbidities.
- Comorbid patients showed a significantly higher proportion of moderate-to-high cardiovascular risk or existing cardiovascular disease.
Conclusions:
- Over a third of patients with newly identified "limit" hypercholesterolemia have comorbidities.
- 1 in 10 patients face high 10-year cardiovascular mortality risk based on SCORE assessment.
- Lipoprotein ratios and cardiovascular risk are substantially elevated in patients with comorbidities.
Background:
For a proper approach to the subjects, in which the presence of hypercholesterolemia is identified for the first time, is important to consider simultaneously both cardiovascular risk factors and the presence of other diseases. The purpose of our study was to describe the lipid profile of patients in which the presence of hypercholesterolemia is detected for the frist time and to determine their cardiovascular risk and comorbidity.
Methods:
Observational cross-sectional study in a Primary Care setting. In 274 subjects with a plasma cholesterol level higher or equal to 200 mg / dL ("limit" hypercholesterolemia), selected by consecutive sampling, we assessed: lipid profile, cardiovascular risk factors and cardiovascular risk (SCORE and Castelli's atherogenic index), comorbidity (Charlson's Index) and sociodemographic characteristics.
Results:
The mean cholesterol level was 232.9 mg/dl. Hypercholesterolaemia was reported "definite" (>= 250 mg / dl) in 21.1% (95% CI: 16.2 to 26.1). A 9.5% showed a cardiovascular risk >= 5%. Lipoprotein ratio of total cholesterol/HDL cholesterol was higher in men than in women (4.4 vs. 3.8, p <0.001) in subjects with Charlson's Comorbidity Index > = 1 (4.1 vs. 3.9, p = 0.04), in smokers (4.3 vs. 3.9, p = 0.04) and in hypertensive subjects (4.2 vs. 3.9, p = 0.03), obese (4.2 vs 3 , 7, p <0.05) or with the metabolic syndrome (4.4 vs 3.9, p = 0.02). We observed a higher proportion of subjects with moderate cardiovascular risk / high or cardiovascular disease in those with comorbidity (87.3% vs 42.3%, p <0.01).
Conclusions:
More than a third of the subjects in which "limit" cholesterol was identifiyed for the first time presents comorbidity, being "defined" hypercholesterolemia in 21.1% of the cases. Takeing in consideration the Score function assessment, one outif 10 subjects presents high cardiovascular mortality risk after 10 years. Both lipoprotein ratio and cardiovascular risk are markedly higher in subjects with comorbidity.
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