ACTIVE INTERVENTIONS IN HYPERCHOLESTEROLOEMIA PATIENTS WITH HIGH CARDIOVASCULAR RISK IN PRIMARY CARE; ESTUDIO ESPROCOL

作者：Tarraga Lopez Pedro J; Garcia Norro Herreros E J; Tarraga Marcos Loreto; Solera Albero Juan; Gonzalez Lopez Esteban; Ruiz Garcia Antonio; Pallares Carratala Vicente; Castro Navarro Jose Luis; Alins Presas Josep; Panisello Royo Josefa Maria

来源：Nutricion Hospitalaria, 2015, 31(6): 2727-2734.

DOI：10.3305/nh.2015.31.5.8998

• Secondary prevention
• Control of hypercholesterolemia
• Therapeutic inertia

Introduction: hypercholesterolemia is a major modifiable risk factors for cardiovascular disease (CVD). Its reduction reduces morbidity and mortality from ischemic heart disease and CVD in general, primary prevention and secondary prevention especially.
Objective: to determine whether a notarized and intensive clinical practice can overcome inertia and achieve the therapeutic goal (OT) LDL-C <100 mg / dL in high-risk patients attended in Primary Care (PC) in our country.
Methodology: epidemiological, prospective, multicenter study conducted in centers of different ACs By AP consecutive sampling 310 patients at high cardiovascular risk (diabetic or established CVD) previously treated with statins, which did not reach the OT included c-LDL.
Results: the study subjects had a mean age of 65.2 years, of which 60.32% were male. The 41.64 % had a previous EVC, acute myocardial infarction (20.33 %), angina (16.07 %), stroke / TIA (9.19 %), arthropathy (5.25 %), diabetes (70.87 %), hypertension (71.01 %), and abdominal obesity (69.62%). The 43.57 % (95 % CI: 37,21; 50,08) of patients who performed the 2nd visit (241) got the OT. 62.50 % (95 % CI: 55.68, 68.98) of those who took the 3rd (216) got the OT. Finally, 77.56 % (95 % CI: 72.13, 83.08) patients who performed the last visit (205) got the OT. Throughout the study there was a reduction in LDL-C levels from 135.6 mg / dL at baseline, 107.4 mg / dL in the 2nd visit, 97.3 mg / dL in the 3rd visit, up to 90.7 mg / dL at the final visit (p < 0.0001) The increase in HDL-C from baseline (50.9 mg / dL) and final (53.6 mg / dL) was also significant (p = 0.013).
Conclusions: the reassessment and intensification of treatment in patients at high cardiovascular risk treated in primary care, applying the indications of the guides, achieves the OT in more than three quarters of the previously uncontrolled within half a year. These results should encourage us to overcome the therapeutic inertia in the control of CVD by early and energetic performance against hypercholesterolemia.

• 出版日期2015-6