title: Prevalence of dyslipidemia in statin-treated patients in the Baltic states (Estonia, Latvia, and Lithuania): results of the Dyslipidemia International Study (DYSIS).
abstract: OBJECTIVE
  The Baltic nations (Estonia, Latvia, and Lithuania) are profoundly affected by cardiovascular disease (CVD). Studies have indicated that patients may experience persistent dyslipidemia despite chronic statin treatment. Therefore, the aim of this study was to analyze the risk factors for dyslipidemia despite statin-treatment in a large dataset from the Baltic nations.
  
  
  METHODS
  Patients in primary care centers across the Baltic nations were enrolled into the cross-sectional, observational Dyslipidemia International Study (DYSIS). Patients were ≥ 45 years old and had been treated with statins for at least three months. Patient characteristics and lipid measurements were used to determine variables contributing to dyslipidemia (abnormal low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], or total triglyceride [TG] values).
  
  
  RESULTS
  We enrolled 1797 patients with a mean age of 66.1 years and 59.1% being female. Overall 63.4% had cardiovascular disease, 30.1% were diabetic and 77.8% at high risk for cardiovascular complications. LDL-C was not at target level for 80.7%; low HDL-C levels were observed for 26.0%, and elevated TG levels were found in 35.0% of all patients. Multivariate analyses indicated that a BMI ≥ 30 kg/m(2) (OR, 2.12; 95% CI, 1.45-3.08) and hypertension (OR, 2.43; 95% CI, 1.1 6-5.10) were strongly associated with dyslipidemia (involving all three lipids) during statin therapy while age ≥ 70 years (OR, 0.63; 95% CI, 0.42-0.94) and female gender (OR, 0.48; 95% CI, 0.33-0.68) conferred reduced risk.
  
  
  CONCLUSIONS
  Our findings indicate many statin-treated patients in Estonia, Latvia, and Lithuania did not meet target lipid levels and had a very high risk of CVD. Combating other well-known CVD risk factors such as obesity and hypertension is vital to reduce the exceptionally high risk for CVD mortality seen in the Baltic nations.
authors: North Estonia Medical Centre, Tallinn University of Technology, Tallinn, Estonia. Electronic address: margus.viigimaa@regionaalhaigla.ee.
authors: Margus
authors: M
authors: Viigimaa
authors: Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors: Andrejs
authors: A
authors: Erglis
authors: Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors: Gustavs
authors: G
authors: Latkovskis
authors: East Tallinn Central Hospital, Tallinn, Estonia.
authors: Ene
authors: E
authors: Mäeots
authors: Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors: Žaneta
authors: Ž
authors: Petrulionienė
authors: Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors: Rimvydas
authors: R
authors: Šlapikas
authors: MSD UAB, Vilnius, Lithuania.
authors: Anete
authors: A
authors: Gocentiene
authors: Institut für Pharmakologie und Präventive Medizin, Mahlow, Germany.
authors: Peter
authors: P
authors: Bramlage
authors: Merck & Co., Inc., Whitehouse Station, NJ, USA.
authors: Philippe
authors: P
authors: Brudi
mesh_terms: D000368:Aged; D050171:Dyslipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007844:Latvia / Q000453:epidemiology; D008019:Life Style; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; Dyslipidemia; High-density lipoprotein cholesterol; Low-density lipoprotein cholesterol; Statins; Triglycerides