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Frequency of Testing for Dyslipidemia: An Evidence-Based Analysis
Insights
This study found insufficient evidence to determine the optimal frequency of lipid testing for dyslipidemia. Current guidelines suggest testing based on individual cardiovascular risk.
Area of Science:
- Cardiovascular Health
- Clinical Practice Guidelines
- Health Services Research
Background:
- Dyslipidemias, including high LDL cholesterol and triglycerides, are significant risk factors for cardiovascular disease (CVD) in Canada.
- High LDL cholesterol prevalence increases with age, affecting approximately 23% of Canadian adults.
- A high total cholesterol to HDL ratio, a marker for dyslipidemia, was observed in about 15% of participants.
Purpose of the Study:
- To evaluate the frequency of lipid testing in adults without diagnosed dyslipidemia.
- To assess the frequency of lipid testing in adults undergoing treatment for dyslipidemia.
Main Methods:
- A systematic literature review was conducted.
- Included studies published between January 1, 2000, and November 29, 2012.
- Focused on randomized controlled trials, systematic reviews, health technology assessments, and observational studies.
Main Results:
- Only two observational studies assessed lipid testing frequency, with significant limitations.
- Data from these studies were not originally collected to determine testing frequency, hindering conclusions.
- The quality of evidence was deemed very low due to limitations and generalizability issues.
Conclusions:
- No definitive conclusions on lipid testing frequency could be drawn from the reviewed studies.
- Existing guidelines recommend lipid testing for individuals at increased cardiovascular risk.
- The recommended frequency of testing is determined by an individual's cardiovascular risk profile.
Background:
Dyslipidemias include high levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides and low levels of high-density lipoprotein (HDL) cholesterol. Dyslipidemia is a risk factor for cardiovascular disease, which is a major contributor to mortality in Canada. Approximately 23% of the 2009/11 Canadian Health Measures Survey (CHMS) participants had a high level of LDL cholesterol, with prevalence increasing with age, and approximately 15% had a total cholesterol to HDL ratio above the threshold.
Objectives:
To evaluate the frequency of lipid testing in adults not diagnosed with dyslipidemia and in adults on treatment for dyslipidemia.
Research Methods:
A systematic review of the literature set out to identify randomized controlled trials (RCTs), systematic reviews, health technology assessments (HTAs), and observational studies published between January 1, 2000, and November 29, 2012, that evaluated the frequency of testing for dyslipidemia in the 2 populations.
Results:
Two observational studies assessed the frequency of lipid testing, 1 in individuals not on lipid-lowering medications and 1 in treated individuals. Both studies were based on previously collected data intended for a different objective and, therefore, no conclusions could be reached about the frequency of testing at intervals other than the ones used in the original studies. Given this limitation and generalizability issues, the quality of evidence was considered very low. No evidence for the frequency of lipid testing was identified in the 2 HTAs included. Canadian and international guidelines recommend testing for dyslipidemia in individuals at an increased risk for cardiovascular disease. The frequency of testing recommended is based on expert consensus.
Conclusions:
Conclusions on the frequency of lipid testing could not be made based on the 2 observational studies. Current guidelines recommend lipid testing in adults with increased cardiovascular risk, with the frequency of testing based on individual cardiovascular risk.
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