title: Cholesterol control in stroke prevention in Italy: a cross-sectional study in family practice.
abstract: BACKGROUND
  Stroke represents worldwide the second and seventh cause of death and invalidity, respectively. Patients with ischaemic stroke or transitory ischaemic attack (TIA) are at high risk of recurrence, therefore requiring intensive treatment. Hypercholesterolaemia is a modifiable risk factor for stroke. The general practitioners attitude towards detection and treatment of dyslipidaemia among patients with stroke or TIA in Italy is unknown; we therefore aimed to address this issue taking advantage of the database of The Italian College of General Practitioners.
  
  
  METHODS
  Prevalence of the monitored factors (lipid levels, statin prescription, and lipid level control with hypolipidaemic agents prescription) were analysed on a patient population of 465 061.
  
  
  RESULTS
  A total of 2555 (49% women and 51% men) patients with a diagnosis of stroke and 2755 patients (52% women and 48% men) with a diagnosis of TIA were included in the study. Total plasma cholesterol (TC) was reported in more than 60% of the patients and low-density lipoprotein cholesterol (LDLc) and high-density lipoprotein cholesterol (HDLc) in less than half. Total plasma cholesterol and LDLc were controlled in 70.3 and 72.8% of the patients, respectively. The percentage of controlled patients decreased to 64% when both LDLc and TC were considered. Statins and fibrates were prescribed in a small proportion of patients (16.9 and 3.5%, respectively). An acceptable control of blood lipids was achieved in a majority of those patients (60.2%). However a relatively large number of patients (646) with high plasma lipids remained untreated.
  
  
  CONCLUSIONS
  Monitoring and intervention strategies on plasma lipid levels in patients with a diagnosis of stroke or TIA need to be improved.
authors.affiliation: Italian College of General Practitioners, Florence, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filippi
authors.forename: Elena
authors.initials: E
authors.lastname: Tragni
authors.forename: Angelo A
authors.initials: AA
authors.lastname: Bignamini
authors.forename: Emiliano
authors.initials: E
authors.lastname: Sessa
authors.forename: Giovanni
authors.initials: G
authors.lastname: Merlini
authors.forename: Ovidio
authors.initials: O
authors.lastname: Brignoli
authors.forename: Giampiero
authors.initials: G
authors.lastname: Mazzaglia
authors.forename: Alberico L
authors.initials: AL
authors.lastname: Catapano
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy / Q000517:prevention & control*; D015994:Incidence; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000517:prevention & control*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011336:Probability; D012042:Registries; D018570:Risk Assessment; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control*; D016019:Survival Analysis
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors