Cardiovascular Risk in Patients with Dyslipidemia and Their Degree of Control as Perceived by Primary Care Physicians in a Survey-TERESA-Opinion Study.

OBJECTIVE: The aim of this study was to evaluate, through a survey, the opinion of primary care (PC) physicians on the magnitude of dyslipidemia and its degree of control in their clinical practice. MATERIALS AND METHODS: An ecological study was carried out, in which the physicians were invited to participate by means of an online letter. Data were collected at a single timepoint and were based only on the experience, knowledge, and routine clinical practice of the participating physician. RESULTS: A total of 300 physicians answered the questionnaire and estimated the prevalence of dyslipidemia between 2% and 80%. They estimated that 23.5% of their patients were high-risk, 18.2% were very high-risk, and 14.4% had recurrent events in the last 2 years. The PC physicians considered that 61.5% of their patients achieved the targets set. The participants fixed the presence of side-effects to statins at 14%. The statin that was considered safest with regard to side-effects was rosuvastatin (69%). CONCLUSIONS: PC physicians in Spain perceive that the CVR of their patients is high. This, together with the overestimation of the degree of control of LDL-C, could justify the inertia in the treatment of lipids. Moreover, they perceive that one-sixth of the patients treated with statins have side-effects.

Tratamiento del anciano con dislipemia / Treatment of older patients with dyslipidemia

La población anciana va en aumento respecto del total y esa tendencia se avivará en los próximos años. Hasta ahora, las pocas evidencias que hay tanto en prevención primaria como secundaria apuntan a que sus valores de colesterol están elevados, a que hay un porcentaje de personas ancianas en tratamiento muy bajo y que su grado de control es francamente mejorable. Las guías actuales orientan a fijar unos objetivos de tratamiento para este segmento de población iguales que para los más jóvenes. Con todo, hay que tener en cuenta ciertas singularidades de esta población, como los cambios biológicos y metabólicos o la mayor incidencia de dislipemia aterogénica, que les van a afectar. Además, en esta población cobran una especial relevancia la calidad y el mantenimiento de la independencia de vida frente a la mera supervivencia, según manifiestan distintas encuestas al respecto. Por todo ello, y por ser la más estudiada actualmente, la pravastatina parece la estatina de elección, sin olvidar el fenofibrato, para el control de los triglicéridos y el riesgo residual (AU)

Elderly persons represent a growing percentage of the total population, and this tendency will become stronger in the coming years. To date, the little evidence available on primary and secondary prevention indicates that this population has high cholesterol levels, that few are under treatment, and that the degree of control requires improvement. Current guidelines recommend that treatment targets in older persons should be the same as those in younger patients. Nevertheless, it is important to remember certain characteristics in older persons, such as biological and metabolic changes or the higher incidence of atherogenic dyslipidemia, which will affect them. Moreover, quality of life and maintaining independence rather than mere survival are especially important in older individuals, as demonstrated by various surveys. Consequently, pravastatin -the most widely studied statin- seems to be the statin of choice for the control of triglycerides and residual risk, although fenofibrate is also useful (AU)