[Opinion from physicians on the need for dyslipidemia screening in cardiovascular risk. Similarities and differences between primary care and other specialties. The DIANA study]. / Opinión de los médicos sobre la necesidad de cribado de la dislipidemia ante el riesgo cardiovascular. Coincidencias y diferencias entre Atención Primaria y otras especialidades. Estudio DIANA.

INTRODUCTION: The clinical inertia in the screening and treatment of patients at high or very high cardiovascular risk leads to the failure to achieve LDLc targets in this population. The aim of the DIANA study was to determine the opinion of doctors about the screening for dyslipidaemia, the usual practice, and the differences between Primary Care physicians and other specialties. MATERIAL AND METHODS: A questionnaire, using the modified Delphi method, included four blocks on dyslipidemic patients with impaired glucose metabolism. RESULTS: Of the 497 participating experts, 58% were Primary Care physicians. There was agreement on the need for dyslipidemia screening in patients with diabetes, ischaemic heart disease or hypertension, although to a lesser extent among Primary Care physicians. Greater significant differences were found in situations such as pre-diabetes or family history of premature cardiovascular disease (86.2% and 88.6% in Primary Care physicians versus 96.1% and 97.6% in other specialties, respectively). There was no agreement on the need for screening in the presence of xanthomas, xanthelasmas or corneal arcus in people under the age of 45 years, with statistically significant differences in the latter. CONCLUSIONS: Dyslipidaemia screening is mainly performed on patients with cardiovascular disease or any major cardiovascular risk factor, and cutaneous lesions of familial hypercholesterolaemia are underestimated. The need for accurate screening and treatment of dyslipidemia in subjects at high cardiovascular risk must be stressed.

[Delphi consensus on management of dyslipidaemia in patients with impaired glucose metabolism: Diana study]. / Consenso Delphi sobre el manejo de la dislipidemia en pacientes con alteración del metabolismo de la glucosa: estudio Diana.

OBJECTIVES: The aim of the present study was to develop a multidisciplinary consensus based on the Delphi system to establish clinical recommendations for the management of dyslipidaemia when hyperglycaemia is present, and the relevant factors that should be taken into consideration when prescribing and monitoring treatment with statins. METHODS: The questionnaire developed by the scientific committee included four blocks of questions about dyslipidaemia in patients with impaired glucose metabolism. The results of the first two blocks are presented here: a) management of dyslipidaemia; b) relevant factors that should be taken into consideration when prescribing and monitoring treatment with statins. RESULTS: Among the 497 experts who participated in the study, an agreement of over 90% was attained for recommending screening for dyslipidaemia in patients with diabetes or pre-diabetes and/or cardiovascular disease or a family history and/or abdominal obesity and/or hypertension. There was a high degree of agreement that a statin is the lipid-lowering treatment of choice, and that it should be switched when side effects develop. Also, the choice of statin and dose should be made according to baseline LDL cholesterol levels, the target to achieve, and the possible drug-drug interactions. CONCLUSIONS: The screening of dyslipidaemia is primarily conducted in patients with cardiovascular disease, or any major cardiovascular risk factor. When prescribing a statin, physicians mainly focus on the ability to reduce LDL cholesterol and the risk of drug interactions.