Related Experiment Videos
[Risk factors in hyperlipidemic patients with coronary heart disease one year after PTCA]
R Kimmerle1, T Wimmer, M Markus
1Klinik für Ernährung und Stoffwechsel, WHO Collaborating Center for Diabetes, Heinrich-Heine-Universität Düsseldorf.
Insights
This study evaluated modifiable risk factors in hyperlipidemic patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). While cholesterol and LDL levels improved, HDL, smoking, and blood pressure remained unchanged, indicating a need for better risk factor management.
Area of Science:
- Cardiology
- Preventive Medicine
- Nutritional Science
Background:
- Coronary heart disease (CHD) patients with hyperlipidemia often have modifiable risk factors.
- Standard medical care's impact on these risk factors post-percutaneous coronary intervention (PCI) in Germany is understudied.
Purpose of the Study:
- To assess the reduction of modifiable risk factors in hyperlipidemic patients with CHD after PCI.
- To evaluate changes in lipid levels, lifestyle, and adherence to treatment.
Main Methods:
- Prospective evaluation of 93 hyperlipidemic patients (<65 years) undergoing PCI.
- Assessment 13 months post-PCI using questionnaires and a 5-day dietary protocol.
- Analysis of cholesterol, HDL, LDL, triglycerides, smoking status, weight, and blood pressure.
Main Results:
- Significant reductions in total cholesterol (299 to 253 mg/dl) and LDL (228 to 189 mg/dl) (p < 0.001).
- HDL, triglycerides, smoking rates, overweight prevalence, and elevated blood pressure remained unchanged.
- High physician contact, but only 32% received dietary counseling and 42% inpatient rehabilitation.
Conclusions:
- While lipid-lowering therapy improved cholesterol and LDL, other critical risk factors like HDL, smoking, and blood pressure require more attention.
- Despite good patient knowledge, high fat intake persists, suggesting a need for enhanced lifestyle interventions and adherence support.
Abstract:
The reduction of modifiable risk factors in hyperlipidemic patients with coronary heart disease (CHD) receiving standard medical care in Germany has not been evaluated before. We identified all patients < 65 yrs of age with marked hyperlipidemia (Cholesterol (Chol) > 250 mg/dl, HDL < 20% Chol) among all patients who underwent PTCA during defined periods 1991/92 in the Cardiology department of the Heinrich-Heine-University. The study patients (n = 93, age 54 +/- 8 yrs, 75 men, 18 women) were evaluated 13 +/- 2 months after PTCA for modification of their risk factors, treatments, knowledge, medications and dietary habits with a structured questionnaire and a 5-day dietary protocol. At follow-up Chol and LDL were significantly reduced from 299 +/- 47 to 253 +/- 43, and from 228 +/- 47 to 189 +/- 42 mg/dl, respectively (p < 0.001). 10% of patients had an LDL < 135 mg/dl. In contrast, HDL (43 +/- 9 mg/dl) and triglycerides (242 +/- 138 mg/dl), the percentage of smokers (40%), of overweight patients (38%) and of patients with elevated blood pressure (43%) remained unchanged. During the observation period the number of contacts with physicians was high (12 (1-40)). 32% of patients participated in dietary counselling by a dietician and 42% in an in-patient rehabilitation programme. In 2/3 of patients the knowledge related to hyperlipidemia and a lipid-lowering diet was good. However, according to the dietary protocols the fat intake was high (37 +/- 7% of total calories). Lipid lowering drugs had been prescribed in 68% of patients, predominantly as monotherapy and in low dosage.(ABSTRACT TRUNCATED AT 250 WORDS)