Control lipídico y factores de riesgo asociados, antes del padecimiento del primer evento cardiovascular / Lipid control and associated risk factors, before suffering from the first cardiovascular event

RESUMEN

Objetivos: Conocer el grado de control lipídico previo al primer accidente cardiovascular en población atendida durante 2013 en Atención Primaria. Analizar la distribución de dichos eventos según intervalos de control de colesterol LDL (LDL-col), colesterol HDL (HDL-col) y triglicéridos (TG). Método: Estudio descriptivo transversal multicéntrico. Sujetos mayores de 18 años atendidos en centros del Servicio (SAP) Baix Llobregat Nord, que habían sufrido un primer evento (ECV) isquémico cardiaco (CI) o cerebral (CV) del 01/01/2013 al 31/12/2013. Mediciones edad, sexo, tabaquismo, hipertensión arterial, diabetes, dislipemia, obesidad, colesterol total (col-tot), LDL-col, HDL-col, TG, presión arterial sistólica, diastólica, IMC, HbA1c, índices aterogénicos, REGICOR, fármacos. Resultados: Trescientos setenta y nueve sujetos afectos, 197 (52%) cardiaco y 182 (48%) cerebral. Doscientos veinticinco (59,4%) varones; edad media en el diagnóstico 68,9 años (DS 13,7), 71,2 (DS 14,4) en CV (p 0,001). Hipertensión 214 (56,5%), diabetes 113 (29,8%), DLP 193 (50,9%). Casos en LDL < 100-159 88%, HDL ≥ 40/50 72,8%, TG < 150 71,3%. Media col-tot 198,3 mg/dl (DS 40,2); LDL-col 121 (DS 33,8), LDL-col < 130 170 (58,6%). Media HDL-col 52,5 mg/dl (DS 15,4) y TG 130,9 mg/dl (DS 73,2) (CI 139,5 [DS 84,2] vs. CV 120,9 [DS 55,9] [p 0,003]). col-tot/HDL-col óptimo 67%, TG/HDL-col óptimo 39,8%. CI col-tot/HDL-col óptimo varón vs. mujer 51,2 vs. 76,9% (p 0,002); TG/HDL-col óptimo varón vs. mujer 28% vs. 53,8% (p 0,004). Conclusiones: La cuantía de eventos fue similar en ambos territorios, y la edad media en el diagnóstico algo mayor en CV. Hipertensión, DLP y obesidad son los FRCV más prevalentes, y su control en prevención primaria es susceptible de mejora. La mayor parte de los casos se agruparon en los intervalos lipídicos LDL < 100-159 mg/dl, HDL ≥ 40/50 mg/dl y TG < 150 mg/dl

ABSTRACT

Objective: To ascertain the degree of lipidic control before the first cardiovascular accident in population attended during 2013 at Primary Care. To analyze the distribution of these events depending on control intervals of cholesterol LDL (LDL-chol), cholesterol HDL (HDL-chol) and triglycerides (TG). Method: A multicentric cross-sectional, descriptive study on above 18-year-old people attended at the centres of the Primari Care Service (PCS) Baix Llobregat Nord, who had suffered a first cardiac or cerebral ischemic attack from 01/01/2013 to 31/12/2013. Variables collected included age,sex, smoking, high blood preassure,diabetes, dyslipidemia (DLP), obesity, total cholesterol (chol-tot), LDL-chol, HDL-chol, TG, systolic and diastolic blood preassure (SBP,DBP), IMC, HbA1c, atherogenic indices, REGICOR, drugs. Results: 379 affected people, among them 197 (52%) heart attack and 182 (48%) stroke (ictus). Two hundred and twenty-five (54.4%) males, diagnosis median age 68.9 years (DS 13.7), 71.2 (DS 14.4) in CV (p .001). High blood preassure 214 (56.5%), diabetes 113 (29.8%), DLP 193 (50.9%). Cases in LDL< 100-159 88%, HDL ≥ 40/50 72.8%, TG < 150 71.3%. chol-tot average 198.3 mg/dl (DS 40.2), LDL-chol121 (DS 33.8), LDL-chol < 130170 (58.6%). HDL-chol average 52.5 mg/dl (DS 15.4) and TG 130.9 mg/dl (DS 73.2) (CI139.5 [DS 84.2] vs. CV 120.9 [DS 55.9] [p .003]). Optimal chol-tot/HDL-chol 67%, optimal TG/HDL-chol 39.8%. CIoptimal chol-tot/HDL-chol male vs. female 51.2% vs. 76.9% (p .002); optimal TG/HDL-chol male vs. female 28% vs. 53.8% (p .004). Conclusions: The quantity of events was similar in both cardiac and cerebral territories, whereas the median age in the diagnosis was a little higher in CV. High blood preassure, DLP and obesity are the most prevalent FRCV, and its control at primary prevention is improvable. Most of the cases were grouped in the LDL lipid ranges < 100-159 mg/dl, HDL ≥ 40/50 mg/dl and TG < 150 mg/dl