[How many patients need treatment for hypercholesterolemia?]

OBJECTIVE

To find out the percentage of individuals from a population who need pharmacologic treatment for their hypercholesterolemia according to different guidelines.

DESIGN

Descriptive transversal study.

SETTING

Population from 6 areas of Lleida (province) including the city of Lleida.

METHOD

The study has been done on a randomized sample of 401 individuals. First the cardiovascular risk from the equation in the Framingham study was calculated, then the percentage of individuals who should be treated with lipid-lowering medication according to the US National Cholesterol Education Program, The European Society of Atherosclerosis and The Spanish Society of Atherosclerosis.

RESULTS

The prevalence of individuals with cholesterolemia > 250 mg/dl has been 16.3% among men and 22.4% in women. According to NCEP, 20.5% of men and 17.6% of women from 383 individuals older then 6 years old need pharmacologic treatment for hypercholesterolemia. The Framingham equation was applied to 281 individuals (over 30 and under 75 years old) estimating a risk higher than 20% in 10 years for 13.7% of the population under study (23.9% in men and 3.5% in women).

CONCLUSIONS

The percentage of patients who need pharmacologic treatment for hypercholesterolemia varies according to the different guidelines employed. We consider necessary the calculation of the cardiovascular risk with the Framingham equation to use lipid-lowering medication in order to achieve a better protection of the population at higher risk of developing a cardiovascular disease.

[The prevalence of antithyroid antibodies in Lleida]

OBJECTIVE

To evaluate the prevalence of autoimmune thyroid antibody, goiter and levels of ioduria in the region of Lleida.

METHODS

Cross-sectional study on a randomized sample of 601 individuals above 6 years old. Examination and palpation of thyroid gland, TSH, T4, FT4, T3, peroxidase antibodies, thyroglobulin antibodies, and ioduria.

RESULTS

The prevalence of positive peroxidase antibodies was 3.4% (IC 95%: 0.9-5.9), and that of positive thyroglobulin antibodies 9.7% (IC 95%: 6.5-12.9). Palpable goiter was found in 18.3% of individuals, and visible goiter in 13.3%. The mean ioduria was 120.2 +/- 68 mg/l. The mean TSH value was higher in the individuals with thyroid autoimmunity (3.4 +/- 2.4 mU/l) than in the rest (1.6 +/- 1.2 mU/l) the difference was significant.

CONCLUSIONS

Although cases of hypothyroidism are common in populations with iodine deficiency, in regions with adequate iodine intake justifies monitoring for hypothyroidism in these populations as well.

[The prevalence of thyroid functional disorders in the province of Lleida]

OBJECTIVE

To assess the prevalence of thyroidal disorders in our area using a representative sample of the population in terms of age and distribution by sex.

DESIGN

Descriptive observational transversal study.

SETTING

Six areas from the province of Lleida including its capital.

PARTICIPANTS

All the inhabitants older than 6 and living in the region during the time of the study.

MEASUREMENTS AND MAIN RESULTS

The study was carried out using a representative sample of the population. Several demographic and clinical parameters that are considered to be related to thyroidal disorders were gathered. A blood sample was performed to measure thyrotropin and thyroidal hormones (total T3, free T3 and free T4) and antithyroidal antibodies. 4 diagnostic categories were defined: overt hypothyroidism, subclinical hypothyroidism, overt hyperthyroidism and subclinical hyperthyroidism. Blood samples from 401 individuals were analyzed. The prevalence of hyperthyroidism has been 5.6% +/- 2.3% of which 4.6% +/- 2.1% corresponds to subclinical hyperthyroidism. The prevalence of hypothyroidism has been 3.48% +/- 1.7% with 1.24% of overt condition and 2.23% of subclinical. We have not found statistical significance by sex in hyperthyroidism while the prevalence of hypothyroidism is significantly higher among women. 42.8% of hypothyroidism showed positive values for antithyroidal antibodies.

CONCLUSIONS

The prevalence of thyroidal disorders in the studied area is similar to those other regions with an adequate iodine intake. Hypothyroidism has diminished in the last years. Hyperthyroidism has not changed. Data about prevalence of thyroidal disorders will have increased value in the future if strategies such as screening and treatment of subclinical disorders prove to be beneficial.