Dyslipidemia Widespread in Those at High Risk for Heart Disease

Those at highest risk for cardiovascular disease, generally have the lowest level of control of their high cholesterol levels.

Dyslipidemia is common among people who are at high risk for cardiovascular disease. "Given the significance of cardiovascular disease a public health problem in the US and the proven benefits of lipid-lowering therapy for primary prevention," the researchers observe, "efforts to improve the treatment and control of dyslipidemia and to eliminate disparities in dyslipidemia management should be considered among our highest national healthcare quality improvement priorities."

Dr. David C. Goff, from Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues evaluated 6704 subjects aged 45 to 84 years participating in an atherosclerosis study who were free of clinical cardiovascular disease at baseline between 2000 and 2002.

Overall, the prevalence of dyslipidemia was 29.3%, the authors report. Only 54% of those with dyslipidemia were taking lipid-lowering drugs, and of those receiving treatment, only 40.6% were controlled to goal.

Dr. Goff’s group observed that men were approximately 30% more likely than women to have dyslipidemia, but those with dyslipidemia were 20% less likely than women to be receiving treatment and 30% less likely to have achieved treatment goals.
The prevalence of dyslipidemia was 11.7% among subjects at low risk, 33.6% among those at intermediate risk, and 48.9% among those at high risk of cardiovascular disease. More than 80% of those in the low-risk group were being treated, compared with only about half of the higher risk groups.

Dr. Goff and his associates report that the prevalence of dyslipidemia is similar among ethnic groups, except for Chinese Americans, who were less likely to be affected. However, African Americans and Hispanic Americans were less likely to be treated and controlled than non-Hispanic whites.

This, the team suggests, is likely due to socioeconomic characteristics and healthcare access.
Circulation 2006;113:647-656.

================================

DID YOU KNOW:
Diabetes and Mental Illness: A Deadly Duo: Patients with diabetes who have mental health issues are less likely than others to receive the intensive medical care they require, according to a study evaluating over 300,000 Veterans Health Administration patients with diabetes. An American research team found that patients with diabetes who had a mental health condition (eg, depressed mood, anxiety, psychosis, manic symptoms, substance use disorders, or personality disorders) were 24% more likely to not undergo A1C testing or tests for LDL cholesterol. They were also 5% more likely to have not received an eye exam. The authors noted that the effect was more pronounced in patients with psychosis, mania, personality disorders, and substance abuse. The investigation was not intended to determine the cause of such disparities, but the researchers hypothesized that difficulty with medication adherence or interactions between providers and patients may contribute to the discrepancy in care. The study was published in the December 12, 2005 Archives of Internal Medicine.