[Low-level agreement between qualitative and quantitative criteria (NCEP-II) proposed by the Ministry of Health for the lipid-lowering drug therapy in persons without coronary artery disease].
BACKGROUND
To evaluate the impact in Catalonia and the agreement between the qualitative (NCEP-II) and quantitative criteria proposed by the Health Ministry for the lipid-lowering drug therapy among individuais without coronary artery disease.


METHODS
Both qualitative (NCEP-II) and quantitative methods were used in individuals without coronary artery disease studied in a random sample of adult populations in Catalonia (n = 304) aged >/= 16 years. Patients with a LDL-cholesterol levels >/= l90 mg/dl or 160-189 mg/dl plus at least two risk factors fulfilled the qualitative criteria for the lipid-lowering drug therapy; patients with a risk >/= 20% in 10 years fulfilled the quantitative criteria. The agreement between both qualitative and quantitative criteria was evaluated by means of the Kappa index.


RESULTS
20% of males and 20.1% of females, and 24% of males and 33.1% of females fulfilled the qualitative and quantitative criteria for lipid-lowering drug therapy, respectively. A low (Kappa = 0.30) and a moderate (Kappa = 0.44) agreement was observed among males and females, respectively, regarding qualitative and quantitative criteria. Increased serum cholesterol was the determinant risk factor for fulfilling qualitative criteria (ORadj) y whereas age, increased blood pressure and increased serum cholesterol were determinants for fulfilling the quantitative criteria.


CONCLUSIONS
The results obtained in this study showed a low agreement between qualitative and quantitative criteria proposed by the report of the Ministry of Health Report to lower cholesterol levels by means of drug therapy among healthy people. Clear and unequivocal criteria to decide what persons are candidates for cholesterol-lowering drug therapy should be developed.
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Direcció General de Salut Pública, Departament de Sanitat, Barcelona, Spain.
D000328:Adult; D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003327:Coronary Disease; D005260:Female; D006296:Health Services / Q000592:standards*; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013030:Spain
D008078:Cholesterol, LDL; D015243:Cholesterol, VLDL; D000960:Hypolipidemic Agents