高风险患者的LDL胆固醇目标水平的实现:一个 (意想不到的) 性别偏见
Martina Berteotti1, Francesco Profili2, Besmir Nreu3
1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Nutrition, metabolism, and cardiovascular diseases : NMCD
|November 23, 2023
概括
患有心血管风险因素的女性不太可能达到推的低密度脂蛋白胆固醇 (LDL-C) 目标. 这凸显了改善女性患者脂质管理的有针对性的干预措施的必要性.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 降低低密度脂蛋白胆固醇 (LDL-C) 对于预防心血管疾病至关重要.
- 流行病学数据收集对于评估医疗保健在控制心血管疾病风险因素方面的有效性至关重要.
研究的目的:
- 确定高风险患者中达到指南推的LDL-C目标的比例.
- 确定LDL-C管理中治疗失败的预测因素,特别关注性别差异.
主要方法:
- 意大利托斯卡纳 (2019-2021) 的卫生行政和实验室数据分析.
- 包括年龄≥45岁,有重大心脏或脑血管不良事件 (MACCE) 和/或2型糖尿病 (T2DM) 的病史的住户.
- 对LDL-C水平与目标 (MACCE<55 mg/dl,没有MACCE的T2DM<70 mg/dl) 的评估.
主要成果:
- 分析了174,200个人的队列;只有11.6%的人达到目标LDL-C水平.
- 女性性别是MACCE患者未能达到LDL-C目标的独立预测因素 (调整后-IRR为0.58,p <0.001).
- 这一发现在没有接受降脂治疗的患者中仍然存在 (调整后-IRR为0.56,p <0.001).
结论:
- 与男性相比,高风险女性实现推的LDL-C目标的概率明显较低.
- 强调需要加强临床医生和患者教育,为高风险女性量身定制的护理途径,以改善脂质管理.
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