title: Low density lipoprotein cholesterol control status among Canadians at risk for cardiovascular disease: findings from the Canadian Primary Care Sentinel Surveillance Network Database.
abstract: BACKGROUND
  To determine the prevalence of uncontrolled LDL-C in patients with high cardiovascular disease (CVD) risks across Canada and to examine its related factors.
  
  
  METHODS
  Non-pregnant adults >20 years-old, who had a lipid test completed between January 1, 2009 and December 31, 2011 and were included in the Canadian Primary Care Surveillance Network (CPCSSN) database were studied. The Framingham-Risk-Score was calculated to determine the risk levels. A serum LDL-C level of >2.0 mmol/L was considered as being poorly controlled. Patients with a previous record of a cerebrovascular accident, peripheral artery disease, or an ischemic heart disease were regarded as those under secondary prevention. Logistic regression modeling was performed to examine the factors associated with the LDL-C control.
  
  
  RESULTS
  A total of 6,405 high-risk patients were included in the study and, of this population, 68% had a suboptimal LDL-C, which was significantly associated with the female gender (OR: 3.26; 95% CI: 2.63-4.05, p < 0.0001) and no medication therapy (OR: 6.31, 95% CI: 5.21-7.65, p < 0.0001). Those with comorbidities of diabetes, hypertension, obesity, and smokers had a better LDL-C control. Rural residents (OR: 0.64, 95% CI: 0.52-0.78, p < 0.0001), and those under secondary prevention (OR: 0.42; 95 % CI: 0.35-0.51, p < 0.0001), were also more likely to have a better LDL-C control.
  
  
  CONCLUSIONS
  A high proportion of high-cardiac risk patients in Canadian primary care settings have suboptimal LDL-C control. A lack of medication therapy appears to be the major contributing factor to this situation.
authors.affiliation: Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. erfanae@mun.ca.
authors.forename: Erfan
authors.initials: E
authors.lastname: Aref-Eshghi
authors.affiliation: Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. jl4125@mun.ca.
authors.forename: Jason
authors.initials: J
authors.lastname: Leung
authors.affiliation: Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. godwinm@mun.ca.
authors.forename: Marshall
authors.initials: M
authors.lastname: Godwin
authors.affiliation: Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. pduke@mun.ca.
authors.forename: Pauline
authors.initials: P
authors.lastname: Duke
authors.affiliation: University of Calgary, Calgary, Alberta, Canada. tyler.williamson@ucalgary.ca.
authors.forename: Tyler
authors.initials: T
authors.lastname: Williamson
authors.affiliation: University of Ottawa, Ottawa, Ontario, Canada. Masoud.mahdavian@gmail.com.
authors.forename: Masoud
authors.initials: M
authors.lastname: Mahdavian
authors.affiliation: Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada. shabnam.asghari@med.mun.ca.|Department of Family Medicine, Faculty of Medicine, Memorial University of Newfoundland, Primary Healthcare Research Unit, Agnes Cowan Hostel, Room 425, Health Sciences Centre, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada. shabnam.asghari@med.mun.ca.
authors.forename: Shabnam
authors.initials: S
authors.lastname: Asghari
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D002318:Cardiovascular Diseases / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D019992:Databases as Topic; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors; D018571:Sentinel Surveillance
chemical_list: D008078:Cholesterol, LDL