Adherence with the National Cholesterol Education Program guidelines in men with chronic spinal cord injury

作者：Lieberman Jesse A^*; Hammond Flora M; Barringer Thomas A; Goff David C Jr; Norton H James; Bockenek William L; Scelza William M

来源：Journal of Spinal Cord Medicine, 2011, 34(1): 28-34.

DOI：10.1179/107902610x12883422813589

• Spinal cord injury
• Coronary heart disease
• Dyslipidemia
• National Cholesterol Education Program
• Guideline adherence

Objective: Describe the management of dyslipidemia and adherence to the National Cholesterol Educational Program (NCEP) guidelines in men with Spinal Cord Injury (SCI)
Research: Cross-sectional study of a consecutive sample of men with SCI presenting to a single site for coronary heart disease (CHD) risk assessment.
Participants/Methods: Men age 45 to 70 with traumatic SCI (ASIA A, B, and C) at least 10 years prior to participation in the study with no prior history of clinical CHD. Medical history, blood-pressure, and fasting lipid panel were used to calculate risk for CHD using NCEP guidelines and the Framingham Risk Score (FRS). Adherence to treatment recommendations and adequacy of control were assessed based on the NCEP guidelines.
Results: 38 men were assessed; 15/38 (39.5%, 95% CI: 24.0-56.6%) had dyslipidemia, defined as an LDL-C above their LDL-C treatment threshold (n = 6) or being on treatment for dyslipidemia (n = 9, for a 60% treatment rate (9/15, 95% CI: 32.3-83.7%)). Of the 9 individuals on treatment, 6 (66.7%) met their treatment goals (for a 40% overall control rate (6/15, 95% CI: 16.3-67.7%)). Dyslipidemia was well controlled in low risk individuals, but control was less common in higher risk individuals.
Conclusions: Dyslipidemia is common in men age 45-70 with chronic SCI and no evidence of clinical cardiovascular disease. Rates of treatment and control of dyslipidemia in this population are far from optimal, especially among the intermediate- and high-risk groups.

• 出版日期2011-1