未经评估:当代患病率,意识,在美国,严重高胆固醇血症(SH)和家族性高胆固醇血症(FH)的控制以及相关的动脉粥样硬化性心血管疾病风险尚不清楚。
未经评估:使用电子健康记录,我们评估了奥姆斯特德县的SH和FH负担,明尼苏达,US,2004年至2015年。我们将SH定义为低密度脂蛋白胆固醇(LDL-C)水平≥190mg/dl,而没有高胆固醇血症的继发原因,将FH定义为荷兰脂质临床网络评分≥6。对照是年龄和性别匹配的LDL-C水平<190mg/dl的个体。
未经评估:SH的年龄和性别调整的点和时期患病率(年龄递归方法)分别为4.44%和8.95%,分别为;21人中有1人患有FH(~1:233名成年人),46.2%有记录诊断.指南建议的目标(LDL-C<100mg/dl和<70mg/dl在一级和二级预防设置,分别)在33.1%和21.2%的SH病例中实现,总体上实现这一目标的女性少于男性(18.6%vs.23.7%,p=0.022)。在对常规风险因素进行调整后,SH患者发生冠心病(CHD)的风险比为1.21(1.05-1.39;p=0.010),患有SH和CHD家族史的患者为2.16(1.57-2.96;p<0.001),患有FH的患者为4.61(2.66-7.97;p<0.001)。SH与CHD的关联随年龄而改变(p交互作用=0.015),这样风险在年轻时更大。
UNASSIGNED:SH是冠心病发病的一个独立危险因素。意识和控制力都很低,强调需要解决的治疗差距(在女性中更为突出)。
UNASSIGNED: Contemporary prevalence, awareness, and control of severe hypercholesterolemia (SH) and familial hypercholesterolemia (FH) and the associated atherosclerotic cardiovascular disease risk in the US are unknown.
UNASSIGNED: Using electronic health records, we assessed the burden of SH and FH in Olmsted County, Minnesota, US, between 2004 and 2015. We defined SH as low-density lipoprotein cholesterol (LDL-C) level ≥190 mg/dl without secondary causes of hypercholesterolemia and FH as a Dutch Lipid Clinic Network score ≥6. Controls were age- and sex-matched individuals with LDL-C level <190 mg/dl.
UNASSIGNED: The age- and sex-adjusted point and period prevalence (age-recursive method) of SH was 4.44% and 8.95%, respectively; 1 in 21 had FH (∼1:233 adults), and 46.2% had a recorded diagnosis. Guideline recommended targets (LDL-C <100 mg/dl and <70 mg/dl in the primary and secondary prevention settings, respectively) were achieved in 33.1% and 21.2% of SH cases, with less women overall achieving the target than men (18.6% vs. 23.7%, p=0.022). After adjustment for conventional risk factors, the hazard ratio for incident coronary heart disease (CHD) in those with SH was 1.21 (1.05-1.39; p=0.010), in those with SH and a family history of CHD was 2.16 (1.57-2.96; p<0.001) and in those with FH was 4.61 (2.66-7.97; p<0.001). The association of SH with CHD was modified by age (p-interaction = 0.015), such that the risk was greater at younger ages.
UNASSIGNED: SH was prevalent and an independent risk factor for incident CHD. Awareness and control were low, highlighting a treatment gap (more prominent in women) that needs to be addressed.