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Metelskaya VA, Shalnova SA, Yarovaya EB, Kutsenko VA, Boytsov SA, Shlyakhto EV, Drapkina OM. Lipoprotein Profile in Populations from Regions of the Russian Federation: ESSE-RF Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:931. [PMID: 35055754 PMCID: PMC8775951 DOI: 10.3390/ijerph19020931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/10/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to describe the dyslipidemia prevalence and pattern among adult populations from different regions (n = 13) of the Russian Federation (RF). Randomly selected samples (n = 22,258, aged 25-64) were studied according to the ESSE-RF protocol. Lipoprotein parameters were estimated by routine methods. Statistical analyses were performed using R software (v.3.5.1). The overall dyslipidemia prevalence was 76.1% (76.9/75.3% for men/women). In women, total cholesterol (TC) and low-density lipoprotein (LDL)-C levels gradually increased with age (from 4.72 to 5.93 and from 2.76 to 3.79 mmol/L, respectively); in men, they reached a maximum by 45-54 (5.55 and 3.55 mmol/L, respectively) and then decreased. No differences in high-density lipoprotein (HDL)-C in men of different ages were found, but slight decreases in HDL-C and apo AI were observed in women by 55-64 years. No pronounced associations between education and lipid levels in men were observed; higher-educated women showed significantly better lipoprotein profiles. Similar associations between lipids and income level were detected. Women from rural areas had higher TC and triglycerides than urban residents. Regardless of sex, rural residents had higher HDL-C and apo AI, and reduced apo B/apo AI. Conclusion: Information on the peculiarities of dyslipidemia prevalence and lipoprotein profile depending on sex, age, residential place, and socioeconomic status is useful for assessing the global ASCVD risk, and for risk modeling based on national data.
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Affiliation(s)
- Victoria A. Metelskaya
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (S.A.S.); (E.B.Y.); (V.A.K.); (O.M.D.)
| | - Svetlana A. Shalnova
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (S.A.S.); (E.B.Y.); (V.A.K.); (O.M.D.)
| | - Elena B. Yarovaya
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (S.A.S.); (E.B.Y.); (V.A.K.); (O.M.D.)
- Department of Probability Theory Faculty of Mechanics and Mathematics Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Vladimir A. Kutsenko
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (S.A.S.); (E.B.Y.); (V.A.K.); (O.M.D.)
- Department of Probability Theory Faculty of Mechanics and Mathematics Lomonosov Moscow State University, 119234 Moscow, Russia
| | - Sergey A. Boytsov
- National Medical Research Center of Cardiology, 121552 Moscow, Russia;
| | | | - Oxana M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia; (S.A.S.); (E.B.Y.); (V.A.K.); (O.M.D.)
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Lee ZV, Llanes EJ, Sukmawan R, Thongtang N, Ho HQT, Barter P. Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region. Lipids Health Dis 2021; 20:33. [PMID: 33858442 PMCID: PMC8051043 DOI: 10.1186/s12944-021-01450-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
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Affiliation(s)
- Zhen-Vin Lee
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Elmer Jasper Llanes
- Division of Cardiovascular Medicine, University of the Philippines, Manila, Philippines
| | - Renan Sukmawan
- Department of Cardiology & Vascular Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Nuntakorn Thongtang
- Division of Endocrinology and Metabolism, Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand
| | | | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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Lertwanichwattana T, Rangsin R, Sakboonyarat B. Prevalence and associated factors of uncontrolled hyperlipidemia among Thai patients with diabetes and clinical atherosclerotic cardiovascular diseases: a cross-sectional study. BMC Res Notes 2021; 14:118. [PMID: 33766082 PMCID: PMC7993520 DOI: 10.1186/s13104-021-05535-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/17/2021] [Indexed: 11/12/2022] Open
Abstract
Objectives The research aimed to determine the prevalence and associated factors of uncontrolled hyperlipidemia among Thai patients with the disease and Clinical ASCVD. Results A total of 1,527 Thai diabetic patients with a history of ASCVD were included in the study. Uncontrolled hyperlipidemia was detected among 1,216 patients (79.6%; 95% CI 77.6–81.7). The independent factors associated with uncontrolled hyperlipidemia included being female (adjusted odds ratio (AORs); 1.5, 95% CI 1.2–2.0), using thiazolidinedione (AORs; 1.7, 95% CI 1.1–2.7), community hospital (AORs; 4.3, 95% CI 1.0–18.0) and BMI level at 18.5–22.9 kg/m2 (AORs; 2.2, 95% CI 1.2–4.0), 23.0–24.9 kg/m2 (AORs; 1.8 95% CI 0.9–3.3), 25.0–29.9 kg/m2 (AORs; 2.3 95% CI 1.3–4.3) and ≥ 30 kg/m2 (AORs; 2.5 95% CI 1.3–4.9).
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Affiliation(s)
- Teeraboon Lertwanichwattana
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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Drug Treatment of Hyperlipidemia in Chinese Patients: Focus on the Use of Simvastatin and Ezetimibe Alone and in Combination. Am J Cardiovasc Drugs 2019; 19:237-247. [PMID: 30714088 DOI: 10.1007/s40256-018-00317-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Elevated serum low-density lipoprotein cholesterol (LDL-C) is a major risk factor for coronary heart disease (CHD). Many guidelines recommend LDL-C as a primary treatment target, and statins represent the cornerstone of treatment for lipid management. Recently revised guidelines recommend even more intense management of LDL-C, especially in patients at moderate and high risk. However, LDL-C levels in the Chinese population differ from those in Western populations, and the benefits and safety of the maximum allowable dose of statins have yet to be determined. Furthermore, in practice, many patients do not achieve the increasingly stringent LDL-C goals. Consequently, alternative approaches to lipid management are required. Combination therapy with ezetimibe and a statin, which have complementary mechanisms of action, is more effective than statin monotherapies, even at high doses. Several clinical studies have consistently shown that combination therapy with ezetimibe and simvastatin lowers LDL-C more potently than statin monotherapies. Moreover, the safety and tolerability profile of the combination therapy appears to be similar to that of low-dose statin monotherapies. This review discusses the role of simvastatin in combination with ezetimibe in controlling dyslipidemia in Chinese patients, particularly the efficacy and safety of combination therapy in light of recently published clinical data.
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Lin X, Xu R, Fang L, Chen W, Hu D, Zhao S, Wang Y, Li J, Yan X. Factors influencing low-density lipoprotein cholesterol target achievement in primary care - Results from DYSIS China. Int J Cardiol 2016; 222:51-56. [PMID: 27454615 DOI: 10.1016/j.ijcard.2016.07.047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Accepted: 07/04/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Primary care facilities are the base for hypercholesterolemia treatment. However, data regarding the effectiveness of lipid management in primary care are lacking. METHODS AND RESULTS To evaluate lipid management in the primary care setting in China, we compared patients' characteristics and lipid management outcomes between 6100 outpatients treated at primary care versus 19,217 patients in non-primary settings using data from the DYSlipidemia International Study-China (DYSIS-CHINA). Compared to patients treated at non-primary hospitals, patients who received treatment at primary settings were younger, thinner, and were more likely to be female and to have a family history of premature CVD. Overall, 26.8% of very high-risk and 40.8% of high-risk patients achieved the LDL-C target with primary care treatment, whereas these target rates were 41.2% (p<0.001) and 58.6% (p<0.001), respectively, among patients treated at non-primary hospitals. High-dose statin therapy was underused in primary care patients compared to non-primary hospital patients (p<0.001). Logistic regression analysis showed that female gender, diabetes, and obesity were negative factors, whereas life-style modification and use of high-dose statin (40mg/d simvastatin equivalent) were favorable factors in predicting LDL-C target attainment in the primary care setting. CONCLUSION Sedentary life style, alcohol drinking, and use of suboptimal statin dosage are key factors that unfavorably affect the LDL-C target rate among patients treated at primary care facilities in China. Sufficient training for primary care physicians regarding proper statin use and support for the combined use of a statin with ezetimibe could promote LDL-C target attainment in primary care.
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Affiliation(s)
- Xue Lin
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - RuiYi Xu
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ligang Fang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Chen
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Dayi Hu
- Department of Cardiology, Peking University People's Hospital, No.11, Xi Zhi Men Nan Da Jie, Xicheng District, Beijing 100044, China
| | - Shuiping Zhao
- Department of Cardiology, Second Xiangya Hospital, Central South University, No.139, People Street (M.), Changsha 410011, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xi Li, Dongcheng District, Beijing 100050, China
| | - Jihu Li
- MSD China Holding Co., Ltd., No. 1601, Nanjing Rd.(W), JingAn District, Shanghai 20004, China
| | - Xiaowei Yan
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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