Characteristics of patients with uncontrolled arterial hypertension and/or dyslipidemia in primary care in Czechia– LipitenCliDec Study: 1st phase results
Authors:
Martin Šatný; Jana Mašková; Eva Tůmová; Jiří Laštůvka; Michal Vrablík
Authors‘ workplace:
III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in:
AtheroRev 2020; 5(1): 47-52
Category:
clinical studies
Overview
Introduction: The aim of the observational, multicentre study LipitenCliDec was to map the level of control of cardiovascular (CV) risk factors and characterize the patient population who failed to reach the recommended blood pressure and/or lipid target values in daily practice. Another important outcome of this study should be the capture of patients meeting the criteria for familial hypercholesterolemia (FH) as defined by the MedPed (Make Early Diagnosis to Prevent Early Deaths in Medical Pedigrees) project aimed at early detection and proper treatment of these patients.
Methods: The study was conducted at GPs who offered participation to all consecutive patients diagnosed with arterial hypertension (AH) as well as dyslipidaemia where AH and/or dyslipidaemia are not controlled (blood pressure > 140/90 mm Hg, dyslipidaemia as recommended ESC/EAS Guidelines for management of dyslipidaemia 2016.
Results: Out of the 3769 enrolled patients, 55.3% were males (median age 61 years) and 44.6 % were females (median age 64 years). Lipid profile – mean (standard deviation – SD), [mmol/L]: total cholesterol 5.81 (1.32), LDL-C 3.52 (1.12), HDL-C 1.44 (0.58), non-HDL- C 4.37 (1.32), triglycerides 2.11 (1.37). Blood pressure (BP) – mean (SD), [mm Hg]: systolic BP 143.9 (16.3) and diastolic BP 85.4 (10.5). The proportions of the CV risk categories across the study population were: very high 22.9 %, high 29.5 %, moderate 35.1 % and low 12.6 %. 2627 patients (69.7 %) were eligible for calculation of 10-years CV risk according to the Systematic Coronary Risk Evaluation (SCORE) tables. FH was suspected in 256 (10.6 %) out of the 2 356 patients, who were evaluated for FH diagnosis.
Conclusion: In LipitenCliDec study, CV risk factors were quantified in the target population of patients diagnosed with uncontrolled arterial hypertension (AH) and/or dyslipidaemia by each CV risk category and in total. Most patients in the study population fall into the category of very high and high CV risk due to manifest CV disease, or the presence of diabetes or renal disease.
Keywords:
arterial hypertension – cardiovascular risk factors – dyslipidaemia – familial hypercholesterolemia – study LipitenCliDec
Sources
- Townsend N, Wilson L, Bhatnagar P et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016; 37(42): 3232–3245. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehw334>.
- Vrablík M, Piťha J, Bláha V et al. Stanovisko výboru České společnosti pro aterosklerózu k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2019. AtheroRev 2019; 4(3): 126–137.
- Widimský J jr, Filipovský J, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2017. Doporučení České společnosti pro hypertenzi. Hypertenze KV Prevence 2018; 7(Suppl): 2–22.
- Widimský J. Léčba hypertenze v každodenní praxi. Interní Med 2010; 12(5): 236–246.
- Kotseva K, Wood D, De Backer G et al. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet 2009; 3733(9667): 929–940. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(09)60330–5>.
- Farnier M, Averna M, Missault L et al. Lipid-altering efficacy of ezetimibe/simvastatin 10/20 mg compared with rosuvastatin 10 mg in high risk hypercholesterolaemic patients inadequately controlled with prior statin monotherapy – The IN-CROSS study. Int J Clin Pract 2009; 63(4): 547–559. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1742–1241.2009.02022.x>.
- Tůmová E, Vrablík M. Stratifikace kardiovaskulárního rizika a nové cílové hodnoty sérových lipidů. Kardiol Rev Int Med 2017; 19(3): 152–156.
- Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24(11): 987– 1003. Dostupné z DOI: <http://dx.doi.org/10.1016/s0195–668x(03)00114–3>.
- Piepoli MF, Hoes AW, Agewall S et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37(29): 2315–2381. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehw106>.
- Štulc T, Šnejdrlová M, Češka R. Prevence kardiovaskulárních onemocnění v běžné klinické praxi: lze dosáhnout zlepšení? Vnitř Lék 2014; 60(11): 931–936.
- Vaclová M, Vrablík M, Freiberger T et al. Projekt MedPed – pacienti s familiární hypercholesterolemií ve středu pozornosti. Kardiol Rev Int Med 2016; 18(3): 203–207.
- Catapano AL, Graham I, De Backer G et al. ESC Scientific Document Group; 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J 2016; 37(39): 2999–3058. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehw272>.
- Vrablík M, Chmelík Z, Lánská V. Kardiovaskulární rizikový profi l u 40letých mužů a 50letých žen v České republice: výsledky průřezové studie. Vnitř Lék 2014, 60(11): 980–986.014, 60(11): 980–986.
- Vrablík M, Freiberger T, Lánská V et al. Projekt Atractiv: zlepšení kardiovaskulární prevence v podmínkách primární péče v České republice. Vnitř Lék 2008; 54(12):1131–1139.
- Mach F, Baigent C, Catapano AL et al. ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020; 41(1):111–188. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehz455>.
- Vrablík M, Piťha J, Blaha V et al. Stanovisko výboru České společnosti pro aterosklerózu k doporučením ESC/EAS pro diagnostiku a léčbu dyslipidemií z roku 2019. AtheroRev 2019; 4(3): 126–137.
- Vorlíčková P, Mayer O, Bruthans J et al. Změny v adherenci k doporučené cílové hodnotě LDL cholesterolu mezi lety 2006 a 2017 u českých pacientů s chronickou ischemickou chorobou srdeční. [The changes in achievement of target LDL-cholesterol levels between 2006 and 2017 in Czech patients with chronic coronary heart disease]. Cor et Vasa 2019: 61(1): 20–26. Dostupné z DOI: <https://doi.org/10.1016/j.crvasa.2018.05.002>.
- McPherson R, Tybjaerg-Hansen A. Genetics of Coronary Artery Disease. Circ Res 2016; 118(4): 564–578. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCRESAHA.115.306566>.
- Khera AV, Won HH, Peloso GM et al. Diagnostic yield and clinical utility of sequencing familial hypercholesterolemia genes in patients with severe hypercholesterolemia. J Am Coll Cardiol 2016; 67(22): 2578–2589. Dostupné z DOI: <http://dx.doi.org/10.1016/j.jacc.2016.03.520>.
- Vrablík M, Freiberger T, Blaha V et al. Souhrn konsenzu panelu expertů European Atherosclerosis Society k otázce diagnostiky a klinickému vedení nemocných s familiární hypercholesterolemií. Hypertenze a KV prevence 2015; 4(2): 44–48.
- Vrablík M, Rašlová K, Vohnout B et al. Real-life LDL-C treatment goals achievement in patients with heterozygous familial hypercholesterolemia in the Czech Republic and Slovakia: Results of the PLANET registry. Atherosclerosis 2018; 277: 355–361. Dostupné z DOI: <http://dx.doi.org/10.1016/j.atherosclerosis.2018.08.008>.
Labels
Angiology Diabetology Internal medicine Cardiology General practitioner for adultsArticle was published in
Athero Review
2020 Issue 1
Most read in this issue
- Uric acid and influence of hyperuricaemia therapy on prevention of atheroscleroris and cardiovascular diseases
- Comments on the new recommendations for dyslipidemia and cardiovascular risk management with regard to diabetes mellitus
- Homocysteine consensus
- Insulin resistance and atherosclerosis: implications for insulin-sensitizing agents