深刻な高コレステロール血症の患者における長期的死亡率は,人種および民族的に多様な米国のコホートから
Jeremy Miles1, Andrea Scotti1, Francesco Castagna1
1Cardiology Division, Montefiore Healthcare Network/Albert Einstein College of Medicine, Bronx, NY (J.M., A.S., F.C., T.K., P.P.L., A.C., S.L., A.L., M.J.G., C.J.R., L.S.).
Circulation
|November 16, 2023
まとめ
重度の高コレステロール血症 (低密度脂質タンパク質コレステロール ≥190 mg/ dL) の死亡率の予測要因は,多様な米国コホートで特定されました. スタチンの使用は時間が経つにつれて減少し,この高リスク集団における一貫した治療と早期発見の必要性を強調しました.
科学分野:
- 心臓病科
- 公衆衛生
- 流行病学
背景:
- 重度の高コレステロール血症 (低密度脂質タンパク質コレステロール ≥190 mg/dL) の死亡率を予測する手段は限られている.
- この研究は,重度の高コレステロール血症の多民族の米国患者コホートにおける死亡率予測因子のよりよい理解の必要性に対処しています.
研究 の 目的:
- 低密度脂質タンパク質コレステロール≥190 mg/ dLを有する多様な米国患者集団における全因死亡率の予測要因を評価する.
- 重度の高コレステロール血症患者のスタチン治療の傾向を分析する.
主な方法:
- 低密度脂質タンパク質コレステロール≥190 mg/dLの18,740人の患者を2010年から2020年まで遡って分析した.
- 18 歳未満の患者,または以前に悪性腫瘍を患った患者を除外する.
- コックスの回帰分析は,人口統計,臨床,治療の変数で調整され,年齢,性別,人種/民族,予防状態による層分化が行われました.
主要な成果:
- 低密度の脂質タンパク質のコレステロールとトリグリセリドのレベルが上昇すると,9年後の死亡リスクが増加した.
- 死亡率の高さに関連した臨床的要因には,男性,高齢,高血圧,慢性腎疾患,糖尿病,心不全,心筋梗塞,低体量指数が含まれていた.
- 脂質を下げる治療は生存に利点をもたらし,スタチンの使用は,特にプライマリ予防のために,時間の経過とともに減少した.
結論:
- 多様な米国の人口の中で重度の高コレステロール血症の死亡率の増加を予測するいくつかの患者の特徴があります.
- スタチンの使用が減少する傾向が観察されました.
- 発見は,重度の高コレステロール血症の早期発見と一貫した治療の重要性を強調し,長期的な結果を改善します.
関連する概念動画
Atherosclerosis III: Management
11
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
11
Cholesterol: Significance and Regulation
556
Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
Considering cholesterol and...
Considering cholesterol and...
556
Blood Studies for Cardiovascular System III: Serum Lipid Profile
166
Understanding serum lipids is crucial for maintaining cardiovascular health and preventing heart disease and stroke.
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
166
Lipids: Dietary Sources and Requirements
757
Lipids are an essential component of a balanced human diet. Triglycerides, which make up the majority of dietary lipids, are found in both saturated fats—commonly present in meat, dairy products, and certain tropical plants like coconut, and hydrogenated oils such as margarine and baking shortenings (trans fats)—and unsaturated fats, which are abundant in seeds, nuts, olive oil, and most vegetable oils. The main sources of cholesterol include egg yolks, various meats and organ...
757
Coronary Artery Disease IV: Preventive Measures
23
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
23
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
672
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
672


