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DIAGNOSIS AND TREATMENT OF PATIENTS WITH SEVERE HYPERCHOLESTEROLEMIA IN REAL OUTPATIENT PRACTICE (ACCORDING TO THE RECVASA REGISTRY)

https://doi.org/10.20996/1819-6446-2014-10-6-612-616

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Abstract

Hypercholesterolemia is a proven risk factor for atherosclerotic cardiovascular diseases and for their complications.

Aim. To assess the quality of diagnosis and treatment of patients with severe hypercholesterolemia (total cholesterol >6.2 mmol/L) in the real outpatient practice.

Material and methods. All patients with a diagnosis of arterial hypertension, ischemic heart disease, chronic heart failure, atrial fibrillation applied to primary care physicians or cardiologists in one of the randomly selected out-patient clinic of Ryazan in March-May 2012 and included into the RECVASA registry were enrolled into the study group (n=1642).

Results. The group of patients with severe hypercholesterolemia consisted of 561 (44%) patients at the age of 67 (59-75) years [Me (25% -75%)]. At that, diagnosis of hyperlipidemia was indicated only in 9% of outpatient cards. Data of one or more blood chemistries including low density cholesterol (LDC) levels were presented only in 7% of outpatient cards. 83.7% of patients with severe hypercholesterolemia were classified as patients at high or very high cardiovascular risk, but statins were recommended only to 17.8% of them. Statins were mainly recommended in moderate doses; only one patient took atorvastatin 40 mg per day. Blood LDC levels were examined only in 5% of patients during statins therapy; nobody of them reached target LDC levels.

Conclusion. The study data revealed the presence of a high prevalence of severe hypercholesterolemia in patients with cardiovascular diseases and poor quality of diagnosis and treatment in these patients in the real outpatient practice.

About the Authors

A. I. Ershova
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


A. N. Meshkov
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


S. S. Yakushin
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


M. M. Loukianov
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


K. A. Moseychuk
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


S. Yu. Martsevich
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


A. V. Zagrebelnyy
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


A. N. Vorobyev
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


K. G. Pereverzeva
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


E. A. Pravkina
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


A. N. Kozminskiy
Ryazan State Medical University named after academician I.P. Pavlov
Russian Federation
Visokovoltnaya ul. 9, Ryazan, 390026 Russia


S. A. Boytsov
State Research Center for Preventive Medicine
Russian Federation
Petroverigsky per. 10, Moscow, 101990 Russia


References

1. World Health Organization. World Health Report 2002: Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization; 2002. Available at: http://www.who.int/entity/whr/2002/en/whr02_en.pdf?ua=1. Accessed by 06/12/2014.

2. Nelson RH. Hyperlipidemia as a risk factor for cardiovascular disease. Prim Care 2013;40(1):195-211.

3. Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364(9438):937-52.

4. Diagnosis and correction of lipid disorders for the prevention and treatment of atherosclerosis. Russian recommendations (V revision). Ateroskleroz i Dislipidemii 2012; 4 (9): 5-53. Russian (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации (V пересмотр). Атеросклероз и Дислипидемии 2012;4 (9):5-53).

5. Catapano AL, Reiner Z, De Backer G, et al. ESC/EAS Guidelines for the management of dyslipidaemias. The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Atherosclerosis 2011;217(1):3-46.

6. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002; 106:3143-421.

7. Diagnostics and correction of lipid disorders for the prevention and treatment of atherosclerosis. Russian recommendations (IV revision). Kardiovaskulyarnaya Terapiya i Profilaktika 2009; 8 (6) suppl 3: 1-58. Russian (Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации (IV пересмотр). Кардиоваскулярная Терапия и Профилактика 2009;8(6) Приложение 3: 1-58).

8. Ищнеыщм SA, Jakushin SS, Martsevich SY, et al. Register outpatient cardiovascular disease in the Ryazan region (REKVAZA): basic tasks, the experience of creation and the first results. Ration Pharmacother Cardiol 2013; 9 (1): 4-14. Russian (Бойцов С.А., Якушин С.С., Марцевич С.Ю., и др. Амбулаторно-поликлинический регистр кардиоваскулярных заболеваний в Рязанской области (РЕКВАЗА): основные задачи, опыт создания и первые результаты. Рациональная Фармакотерапия в Кардиологии 2013;9(1):4-14).

9. Strandberg TE, Kolehmainen L, Vuorio A. Evaluation and treatment of older patients with hypercholesterolemia: a clinical review. JAMA 2014;312(11):1136-44.

10. Arcoraci V, Santoni L, Ferrara R, et al. Effect of an educational program in primary care: the case of lipid control in cardio-cerebrovascular prevention. Int J Immunopathol Pharmacol 2014;27(3):351-63.

11. Boytsov SA, Chuchalin AG, eds. Dispensary observation of patients with chronic non-communicable diseases and patients with a high risk of their development. Methodical recommendations. Moscow: 2014. Available at: http://www.gnicpm.ru/userfiles/диспансерное%...pdf. Accessed by 06/12/2014. Russian (Бойцов С.А., Чучалин А.Г., редакторы. Диспансерное наблюдение больных хроническими неинфекционными заболеваниями и пациентов с высоким риском их развития. Методические рекомендации. М.: 2014. Доступно на: http://www.gnicpm.ru/userfiles/диспансерное%...pdf. Проверено 06.12.2014).


For citation:


Ershova A.I., Meshkov A.N., Yakushin S.S., Loukianov M.M., Moseychuk K.A., Martsevich S.Y., Zagrebelnyy A.V., Vorobyev A.N., Pereverzeva K.G., Pravkina E.A., Kozminskiy A.N., Boytsov S.A. DIAGNOSIS AND TREATMENT OF PATIENTS WITH SEVERE HYPERCHOLESTEROLEMIA IN REAL OUTPATIENT PRACTICE (ACCORDING TO THE RECVASA REGISTRY). Rational Pharmacotherapy in Cardiology. 2014;10(6):612-616. (In Russ.) https://doi.org/10.20996/1819-6446-2014-10-6-612-616

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)