ABSTRACT
Objective@#To investigate the proportion of achieving the blood lipid control target and its influencing factors among residents at a high risk of atherosclerotic cardiovascular disease (ASCVD), so as to provide insights into management of blood lipid among residents at a high risk of ASCVD.@*Methods@#Residents at a high risk of ASCVD and at ages of 35 to 70 years were sampled using a multi-stage cluster sampling method from 6 counties (districts) in Shaoxing City from May to July 2021. The residents' demographics, smoking, alcohol consumption and medical history of chronic diseases were collected using questionnaires, the height, weight, waist circumference (WC) and blood pressure were measured, and the total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and fasting blood glucose were detected. The proportion of blood lipids achieving the control target was analyzed, and factors affecting the proportion of blood lipids achieving the control target were identified using a multivariable logistic regression model.@*Results@#A total of 1 695 individuals at a high risk of ASCVD were enrolled, including 940 men (55.46%) and 755 women (44.54%), with a mean age of (62.56±6.08) years. There were 285 participants that achieved the target of blood lipid control (16.81%). Multivariable logistic regression analysis identified gender (male, OR=1.962, 95%CI: 1.396-2.758), age (OR=1.037, 95%CI: 1.013-1.061), WC (OR=0.979, 95%CI: 0.964-0.995), diastolic blood pressure (OR=0.981, 95%CI: 0.967-0.994), smoking (OR=1.485, 95%CI: 1.034-2.133), alcohol consumption (OR=0.684, 95%CI: 0.498-0.941), hypertension (OR=1.428, 95%CI: 1.006-2.207), administration of hypoglycemic drugs (OR=2.326, 95%CI: 1.720-3.144) as factors affecting the achievement of the target for blood lipid control among residents at a high risk of ASCVD. @*Conclusions @#Individuals at a high risk of ASCVD with higher WC, higher diastolic blood pressure and alcohol consumption are less likely to achieve the target for blood lipid control, while male individuals with older age, hypertension and administration of hypogcemic drugs are more likely to achieve the target for blood lipid control.
ABSTRACT
Objective@#To investigate thestatus and control of blood lipid level among patients with type 2 diabetes mellitus（T2DM）in rural communities of Zhejiang Province，and to provide evidence for blood lipid control for T2DM.@*Methods@#A sample of 10 343 patients with T2DM managed by communities from Jiashan，Suichang and Yongkang in 2016 were recruited. Through the diabetes registry system，physical examination and laboratory tests，data of demographic features，blood pressure，body mass index（BMI），waist circumstance（WC），glycated hemoglobin（HbA1c），total cholesterol（TC），triglyceride（TG），low-density lipoprotein cholesterol（LDL-C）and high-density lipoprotein cholesterol（HDL-C）were collected to learn the status of blood lipid control. Logistic regression analysis was conducted to explore the influencing factors for blood lipid control. @*Results@#The control rate of TC，TG，LDL-C and HDL-C in patients with T2DM was 29.84%，58.72%，48.25% and 61.27%，respectively. About 11.76% of patients had all the four indicators in control，while 9.22% of patients failed in all. The higher control rates of all of the four indicators were seen in males than females，in older age，in lower BMI and in normal people than in central obese people（all P<0.05）. The results of multivariate logistic regression analysis showed that sex（OR=3.556，95%CI：3.070-4.119），age（OR=1.130，95%CI：1.060-1.204），WC（OR=0.989，95%CI：0.980-0.998）， BMI（OR=0.768，95%CI：0.688-0.857），systolic blood pressure（OR=0.991，95%CI：0.984-0.999），HbA1c level（OR=0.914，95%CI：0.876- 0.953），smoking（OR=0.768，95%CI：0.639-0.924）and drinking（OR=0.688，95%CI：0.536-0.884）were associated with the control of TC，TG，LDL-C and HDL-C in patients with T2DM.@*Conclusion@#The control rate of blood lipid is low in patients with T2DM in rural communities of Zhejiang Province，surveillance and interventions should be focused on sex，overweight/obesity，smoking，alcohol intake，blood glucose and blood pressure.
ABSTRACT
Objective To investigate the factors influencing the lipid control success rate among patients with coronary heart disease (CHD).Methods Questionnaire and clinical data reviews were conducted to investigate the general information,disease characteristics and patients controlling blood lipid and by blood biochemical tests were done to detect the lipid levels.The relationships between lipid control success rate and general information,disease characteristics and patients' behaviors were analyzed by chi-square test and logistic regression analysis.Results The blood lipid success rate was only 67.09％ in patients with CHD combined dyslipidemia.The education level,cardiovascular disease risk grading,complications,body mass index,medication compliance and dietary evaluation were the main factors influencing the patients' success in blood lipid control.Conclusion The lipid control success rate can be raised by taking measurements to help patients with CHD and dyslipidemia control weight and increase medication compliance and dietary behavior.
ABSTRACT
Type 2 diabetes mellitus (DM) doubles the risk of major cardiovascular complications in both patients with and those without established cardiovascular disease (CVD), and the majority of patients with DM die of CVD. Therefore, prevention and early diagnosis for CVD are important for the improvement of quality of life and prognosis of patients with DM. Exercise stress tests, such as a treadmill test, are needed to detect myocardial ischemia, but such stress testing should be done by cardiologists. On the other hand, measurement of ankle brachial index (ABI) is quick and easy and has been used successfully to diagnose peripheral artery disease. Since ABI is known to be a good predictor of the risk of recurrent CV events and death, I strongly recommend that ABI be measured in all DM patients. Dipeptidyl peptidase 4 (DPP-4) inhibitors are oral agents with little risk of hypoglycemia and thus used widely. In 2013, two clinical studies (EXAMINE and SAVOR-TIMI53) showed that DPP-4 inhibitors were generally safe and well-tolerated but did not decrease or increase the rate of CV events in patients with high risk for CV. Although the study periods were short (1.5-2.0 years), it was shown that a reduction of CV events in DM patients with CV risk is difficult with glycemic control alone. Results of the Steno-2 study showed that optimal treatment of hypertension and dyslipidemia in addition to glycemic control are needed to reduce CV events.