Prevalence, Treatment, and Control of Hypercholesterolemia in High Cardiovascular Risk Patients: Evidences from a Systematic Literature Review in Spain.
BACKGROUND
Cardiovascular diseases (CVDs) represent a major Public Health burden. High serum cholesterol levels have been linked to major CV risk. The objectives of this study were to review the epidemiology of hypercholesterolemia in high risk CV patients from Spain, by assessing its prevalence, the proportion of diagnosed patients undergoing pharmacological treatment and the degree of attained lipid control.


METHODS
A systematic literature review was carried out using Medline and two Spanish databases. Manuscripts containing information on hypercholesterolemia in several high CV risk groups [diabetes mellitus (DM), Systematic COronary Risk Evaluation (SCORE) risk >5, or documented CVD], published between January 2010 and October 2014, were included.


RESULTS
Of the 1947 published references initially retrieved, a full-text review was done on 264 manuscripts and 120 were finally included. Prevalence of hypercholesterolemia ranged from 50 to 84% in diabetics, 30-60% in patients with DM or elevated SCORE risk, 64-74% with coronary heart disease, 40-70% in stroke patients, and 60-80% in those with peripheral artery disease. Despite the finding that most of them were on pharmacological treatment, acceptable control of serum lipids was very variable, ranging from 15% to 65%. Among those with heterozygous familial hypercholesterolemia, 95-100% received treatment but less than 50% achieved their therapeutic goals.


CONCLUSIONS
An elevated prevalence of hypercholesterolemia can be found in targeted groups at high CV risk. Although most patients are receiving pharmacological treatment, rates of lipid control continue to be low, both in primary and secondary prevention.
Department of Internal Medicine, University Hospital Mutua Terrassa, Barcelona, Spain. adelasierra@mutuaterrassa.cat.
Alex
A
de la Sierra
Lipid Unit, Internal Medicine Service, University Hospital of Bellvitge, Barcelona, Spain.
Xavier
X
Pintó
Internal Medicine Service, University Hospital Alcorcón Foundation, Madrid, Spain.
Carlos
C
Guijarro
Lipids and Atherosclerosis Unit, IMIBIC/Reina Sofıa University Hospital, University of Cordoba and CIBER Fisiopatologia Obesidad y Nutricion, Instituto de Salud Carlos III, Cordoba, Spain.|Reina Sofia University Hospital, IMIBIC/Fundacion para la Investigacion Biomedica de Cordoba, Cordoba, Spain.
José López
JL
Miranda
BAP Health Outcomes Research, Oviedo, Spain.
Daniel
D
Callejo
BAP Health Outcomes Research, Oviedo, Spain.
Jesús
J
Cuervo
Health Economics and Outcomes Research, Sanofi Iberia, Barcelona, Spain.
Rudi
R
Subirà
Health Economics and Outcomes Research, Sanofi Iberia, Barcelona, Spain.
Marta
M
Rubio
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy* / Q000453:epidemiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
D008055:Lipids
Cardiovascular disease; Control; Drug; Dyslipidemia; Hypercholesterolemia; Prevalence