[Strategies for the detection of dyslipemias in primary care in La Rioja]. / Estrategias de detección de dislipemias en atención primaria de La Rioja.

We was carried out a survey between all primary care physicians (PCP) of La Rioja on their social and demographic data, anamnesis on their factors of cardiovascular risk and behavior in the strategies of hypercholesterolemia detection. The 65% of the PCP ask to their patient on knowledge of their cholesterol; this proportion increases between the physicians that know the recommendations of the Spanish Atherosclerosis Society (SAS) (p < 0.002). The 100% of the PCP determine some lipid parameter when they specify a blood sample for another reason or in presence of arterial hypertension, coronary heart disease, dyslipidemias or diabetes mellitus. In presence af smoking habit or oral contraceptive use, PCP that know the SAS or that they work in the rural environment, respectively, they solicit lipid parameters with a greater frequency (p < 0.04 and p < 0.03). Only a 23% of the PCP carry out electrocardiogram in case of a hyperlipidemia, percentage that is incremented between those that works in primary health centers ar in the urban medium (p < 0.03 and p < 0.03). A quarter af the PCP don't refer to the specialized attention to their patients with uncontrolled dyslipidemia and almost the 10% they would not send them under no circumstance. Although in general seem us adequate the behavior in opportunist detection of the PCP, this improves up on knowing the normative of national consensus.

[Treatment of hyperlipemia: opinions of primary care physicians of the La Rioja region]. / Opiniones de los médicos de atención primaria de La Rioja sobre el tratamiento de las hiperlipemias.

BACKGROUND: Primary health care physicians (PHCP) play a fundamental role in the detection and treatment of hyperlipemias in a general population. The aim of this study was to estimate the opinion of the PHCP in the Autonomic Community of La Rioja, Spain, regarding desirable lipemic values and treatment of hyperlipemias. METHODS: A survey with personal interview was carried out to all the PHCP in the Spanish National Health Care (INSALUD) in La Rioja in May and June 1994. RESULTS: Of the 177 PHCP included 97% completed the questionnaire. The main coronary risk factor for 46% of physicians was high blood pressure followed by serum cholesterol (30%). Fifty-six percent of the physicians believed that the desired populational cholesterolemia should be less than 200 mg/dl and this percentage rose if the physician worked in an urban environment (p < 0.01). Sixty-six percent considered 200 mg/dl as the desired triglyceridemia. For treatment and follow-up of hyperlipemia, 78% of physicians use cholesterol linked to low density lipoproteins (cLDL). This use of cLDL increased among those who were familiar with the recommendations of the Spanish Society of Arteriosclerosis (p < 0.002) or who worked in health care centers (p < 0.02). Regarding initiation of dietetic treatment most chose cholesterolemia between 200-250 mg/dl, a cLDL value between 150-185 mg/dl and triglyceridemia between 200-250 mg/dl. For the use of pharmacologic treatment these levels were 250-300 mg/dl, 150-185 mg/dl and 250-300 mg/dl, respectively. Ninety-nine percent of physicians indicated diet as the first therapeutic measure. In isolated hypercholesterolemia the resins were most used by the Family Medicine specialists (p < 0.002) and fibrates (p < 0.03) and statins (p < 0.02) the least used. The use of statins was lower in the physicians working in health care centers (p < 0.03). CONCLUSIONS: Knowledge of theshold values of serum cholesterol and triglicerides levels and the use of drugs among the primary health care physicians from La Rioja, Spain, are generally correct. The physicians with good knowledge of the National Consensus Guides on hyperlipemias had the most adequate opinion.