Risk assessment and treatment of dyslipidemia in primary health care.
BACKGROUND
The aim was to evaluate the practices of routine management of dyslipidemia performed by general practitioners in a large geographic area.


METHODS
Patients were identified by three or more plasma cholesterol measurements registered in the electronic laboratory information system (LIS) covering the total geographic area, and the study population was characterised by information from general practitioners' records, and from a questionnaire sent to the patients. Further information on ischaemic heart disease (IHD) was obtained from the National Hospital register, and information on prescriptions on lipid lowering medications from the National Health Service.


METHODS
A sample of 1163 subjects, monitored by 134 different general practices.


RESULTS
One third of the patients monitored for dyslipidemia had IHD, and two thirds were monitored as part of primary intervention. Dietary counselling was reported by 76%, and 54% were treated with lipid-lowering medications. The treatment frequency was related to cardiovascular risk, increasing from 25% of those with the lowest risk to 72% of the patients with IHD. The treatment goal was not reached in 74% of the cases, but overall a 20% reduction in plasma cholesterol was achieved.


CONCLUSIONS
Subjects monitored for dyslipidemia were relevantly monitored because of IHD or high risk of IHD, and initiated treatment of dyslipidemia was clearly related to the individual assessed risk of IHD. Only a minority reached the treatment goals (< 5 mmol/l), and the statin doses used were generally lower than the doses used in clinical trials.
Kanstrup
Helle
H
Department of Internal Medicine and Cardiology, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. H.Kanstrup@dadlnet.dk
Lassen
Jens Flensted
JF
Heickendorff
Lene
L
Lauritzen
Torsten
T
Larsen
Mogens Lytken
ML
D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000150:complications; D003376:Counseling; D003718:Denmark; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D005194:Family Practice; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires
D000960:Hypolipidemic Agents; D002784:Cholesterol