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1.
J Clin Lipidol ; 13(2): 287-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30797720

RESUMO

BACKGROUND: There is a lack of information on the health care of familial hypercholesterolemia (FH). OBJECTIVE: The objective of this study was to compare the health care of FH in countries of the Asia-Pacific region and Southern Hemisphere. METHODS: A series of questionnaires were completed by key opinion leaders from selected specialist centers in 12 countries concerning aspects of the care of FH, including screening, diagnosis, risk assessment, treatment, teaching/training, and research; the United Kingdom (UK) was used as the international benchmark. RESULTS: The estimated percentage of patients diagnosed with the condition was low (overall <3%) in all countries, compared with ∼15% in the UK. Underdetection of FH was associated with government expenditure on health care (Ï° = 0.667, P < .05). Opportunistic and systematic screening methods, and the Dutch Lipid Clinic Network criteria were most commonly used to detect FH; genetic testing was infrequently used. Noninvasive imaging of coronary calcium and/or carotid plaques was underutilized in risk assessment. Patients with FH were generally not adequately treated, with <30% of patients achieving guideline recommended low-density lipoprotein cholesterol targets on conventional therapies. Treatment gaps included suboptimal availability and use of lipoprotein apheresis and proprotein convertase subtilsin-kexin type 9 inhibitors. A deficit of FH registries, training programs, and publications were identified in less economically developed countries. The demonstration of cost-effectiveness for cascade screening, genetic testing, and specialized treatments were significantly associated with the availability of subsidies from the health care system (Ï° = 0.571-0.800, P < .05). CONCLUSION: We identified important gaps across the continuum of care for FH, particularly in less economically developed countries. Wider implementation of primary and pediatric care, telehealth services, patient support groups, education/training programs, research activities, and health technology assessments are needed to improve the care of patients with FH in these countries.


Assuntos
Atenção à Saúde/estatística & dados numéricos , Hiperlipoproteinemia Tipo II/epidemiologia , Remoção de Componentes Sanguíneos , Doenças Cardiovasculares/complicações , LDL-Colesterol/sangue , Atenção à Saúde/economia , Dietoterapia , Custos de Cuidados de Saúde/estatística & dados numéricos , Educação em Saúde , Humanos , Hiperlipoproteinemia Tipo II/complicações , Hiperlipoproteinemia Tipo II/economia , Hiperlipoproteinemia Tipo II/terapia , Reembolso de Seguro de Saúde , Internacionalidade , Inibidores de PCSK9 , Sistema de Registros , Medição de Risco , Inibidores de Serina Proteinase/farmacologia , Inibidores de Serina Proteinase/uso terapêutico
2.
Asia Pac J Clin Nutr ; 18(2): 234-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19713183

RESUMO

This study aims to assess the prevalence of underweight, overweight and obesity among adults in urban Hanoi, Vietnam; and compare these results to previous estimates among adults in urban Ho Chi Minh City. Survey participants were residents in urban Hanoi, Vietnam and aged between 25-74 years. Data from a cross-sectional biomedical survey conducted in 2004 were collected; which included a questionnaire, physical examination and blood tests. The age-standardised prevalence of overweight and obesity in 2004, using Asian-specific body mass index cut-offs, were 28.6% and 2.1%, respectively. The prevalence of overweight/obesity (combined) was similar in males (29.7%) and females (31.5%), and generally increased with age. The prevalence of overweight/obesity was considerably lower if the standard cut-off values of the World Health Organization were used. The age-standardised prevalence of underweight was 13.3%; and that of 'increased risk'/'substantially increased risk' waist circumference (combined) was 27.9% in males and 25.7% in females, respectively. Almost one in three adults in urban Hanoi were overweight or obese in 2004 and more than one in ten were underweight (based on Asian-specific cut-off values). This prevalence of overweight/obesity is similar to that for adults in urban Ho Chi Minh City, but the prevalence of underweight is lower. While low body weight remains a concern, overweight and obesity are an increasing problem for urban Vietnamese adults.


Assuntos
Obesidade/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Sobrepeso/diagnóstico , Inquéritos e Questionários , Magreza/diagnóstico , População Urbana , Vietnã/epidemiologia , Circunferência da Cintura , Organização Mundial da Saúde
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