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Changing patterns of referral to UK lipid clinics - a ten-year perspective
1Department of Clinical Biochemistry, Royal Free Hospital Hampstead NHS Trust, Pond Street, London NW3 2QG, UK.
Objective:
To review changing attitudes of British physicians to the significance of lipids and associated cardiovascular risks over the last decade.
Methods:
Analysis of annual trends in referrals to specialist UK lipid clinics as recorded in the UK lipid clinics programme computerised database, with data on source, clinical and metabolic status of up to 12932 patients referred from 1986-1995. -
Results:
Over the decade the proportion of referrals from hospital teams rather than GP s, and with clinical vascular disease has increased. The predominantly male patients have been referred at lower initial cholesterol levels but increasing BMI, with less emphasis on rare disorders. Recorded reductions in total cholesterol on treatment have also fallen from some 20% to 13%. Alcohol and smoking habits have been in accord with national trends.
Conclusions:
These changes suggest that awarerness of the significance of cholesterol and particularly of the opportunities available in secondary prevention, and awareness that lipid problems are seen to apply to a much wider patient base than the rare genetic disorders have all increased. However the increasing proportion of cases found at first referral to have lipaemia secondary to other undiagnosed metabolic disturbance suggests that appreciation of such wider influences on lipids remains incomplete.