title: Prevalence of atherogenic dyslipidemia in primary care patients at moderate-very high risk of cardiovascular disease. Cardiovascular risk perception.
abstract: BACKGROUND
  Atherogenic dyslipidemia is an important risk factor for cardiovascular disease. We aim to determine atherogenic dyslipidemia prevalence in primary care patients at moderate-very high cardiovascular risk and its associated cardiovascular risk perception in Spain.
  
  
  METHODS
  This cross-sectional study included 1137 primary care patients. Patients had previous cardiovascular disease, diabetes mellitus, SCORE risk ≥ 3, severe hypertension or dyslipidemia. Atherogenic dyslipidemia was defined as low HDL-C (<40 mg/dL [males], <50 mg/dL [females]) and elevated triglycerides (≥ 150 mg/dL). A visual analog scale was used to define a perceived cardiovascular disease risk score.
  
  
  RESULTS
  Mean age was 63.9 ± 9.7 years (64.6% males). The mean BMI was 29.1 ± 4.3 kg/m(2), and mean waist circumference 104.2 ± 12.7 cm (males), and 97.2 ± 14.0 cm (females). 29.4% were smokers, 76.4% had hypertension, 48.0% were diabetics, 24.7% had previous myocardial infarction, and 17.8% peripheral arterial disease. European guidelines classified 83.6% at very high cardiovascular risk. Recommended HDL-C levels were achieved by 50.1% of patients and 37.3% had triglycerides in the reference range. Target LDL-C was achieved by 8.8%. The overall atherogenic dyslipidemia prevalence was 27.1% (34.1% in diabetics). This prevalence in patients achieving target LDL-C was 21.4%. Cardiovascular risk perceived by patients was 4.3/10, while primary care physicians scored 5.7/10.
  
  
  CONCLUSIONS
  When LDL-C levels are controlled, atherogenic dyslipidemia is more prevalent in those patients at highest cardiovascular risk and with diabetes. This highlights the importance of intervention strategies to prevent the residual vascular risk in this population. Both patients and physicians underestimated cardiovascular risk.
authors.affiliation: Unidad de Medicina vascular y metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili IISPV, CIBERDEM, Reus, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Plana
authors.affiliation: Unidad de Medicina vascular y metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili IISPV, CIBERDEM, Reus, Spain.
authors.forename: Daiana
authors.initials: D
authors.lastname: Ibarretxe
authors.affiliation: Unidad de Medicina vascular y metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili IISPV, CIBERDEM, Reus, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Cabré
authors.affiliation: Departamento Médico, Ferrer Internacional, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ruiz
authors.affiliation: Unidad de Medicina vascular y metabolismo, Hospital Universitario Sant Joan de Reus, Universidad Rovira i Virgili IISPV, CIBERDEM, Reus, Spain. Electronic address: luis.masana@urv.cat.
authors.forename: Lluis
authors.initials: L
authors.lastname: Masana
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology* / Q000209:etiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: Atención primaria; Colesterol high-density lipoprotein; Dislipidemia; Dyslipidemia; Factores de riesgo; High-density lipoprotein cholesterol; Primary health care; Risk factors; Triglicéridos; Triglycerides