[Blood pressure findings in Spanish dyslipidemic primary-care patients. LIPICAP-PA Study]. / Características de la presión arterial en una población dislipémica española asistida en atención primaria. Estudio LIPICAPPA.

BACKGROUND AND OBJECTIVES: Despite the well-known significant relationship between blood pressure and cardiovascular mortality, few data are available on the blood pressure characteristics of dyslipidemic patients. The aims of this study were to determine the blood pressure characteristics of dyslipidemic patients being treated in primary care, and to identify factors associated with poor blood pressure control. METHODS: This multicentre cross-sectional study involved patients of both sexes aged > or =18 years who were diagnosed with dyslipidemia (i.e., hypercholesterolemia, hypertriglyceridemia, mixed dyslipidemia, or a low high-density lipoprotein cholesterol level) in the 17 Spanish autonomous regions. Blood pressure was measured according to standard procedures, and was considered well-controlled if it was <140/90 mm Hg (or <130/80 mm Hg in patients with diabetes, nephropathy or cardiovascular disease). RESULTS: In total, 7054 patients were studied (mean age 61.3 [11.2] years, 50.8% male). Mean systolic and diastolic blood pressures were 134.6 [14.2]/79.8 [8.9] mm Hg, with significant differences (P< .001) between hypertensives (140.8 [14.6]/82.8 [9.0] mmHg) and normotensives (128.5 [10.7]/76.9 [7.7] mm Hg). Good blood pressure control was observed in 47.4% (95% confidence interval, 46.3-48.5%) of subjects overall, in 29.3% of hypertensives, and in 12.8% of hypertensive diabetics. Poor control was associated with an increased cardiovascular disease risk (hazard ratio [HR]=2.89), poor control of low-density lipoprotein cholesterol (HR=1.43), a higher body mass index (HR=1.06), and older age (HR=1.02). CONCLUSIONS: Fewer than half of dyslipidemic primary-care patients in Spain had good blood pressure control. Poor control was associated, in particular, with increased cardiovascular risk and poor control of the low-density lipoprotein cholesterol level.

Características de la presión arterial en una población dislipémica española asistida en atención primaria. Estudio LIPICAP­PA / Blood pressure findings in spanish dyslipidemic primary-care patients. LIPICAP­PA study

Introducción y objetivos. Aunque la presión arterial se ha relacionado significativamente con la mortalidad cardiovascular, se dispone de escasa información sobre sus características en los pacientes dislipémicos. Los objetivos de este estudio fueron conocer las características de la presión arterial en una población dislipémica asistida en atención primaria y los factores que se asocian con el mal control tensional. Métodos. Estudio transversal multicéntrico en el que se analizó a individuos ≥ 18 años de ambos sexos diagnosticados de dislipemia (hipercolesterolemia, hipertrigliceridemia, dislipemia mixta o bajas concentraciones de colesterol unido a lipoproteínas de alta densidad) en las 17 comunidades autónomas de España. La presión arterial se midió siguiendo normas estandarizadas y se consideró bien controlada cuando era < 140/90 mmHg (< 130/80 mmHg en pacientes con diabetes, nefropatía o enfermedad cardiovascular). Resultados. Se analizó a 7.054 pacientes (edad media 61,3 ± 11,2 años; 50,8% varones). Los valores medios de presión arterial sistólica/diastólica fueron de 134,6 ± 14,2/79,8 ± 8,9 mmHg, con diferencias significativas (p < 0,001) entre hipertensos (140,8 ± 14,6/82,8 ± 9,0 mmHg) y normotensos (128,5 ± 10,7/76,9 ± 7,7 mmHg). Se halló buen control de la presión arterial en el 47,4% (intervalo de confianza [IC] del 95%, 46,3-48,5) del total de sujetos, en el 29,3% de los hipertensos y en el 12,8% de los hipertensos diabéticos. El mal control tensional se asoció con la elevación del riesgo cardiovascular (odds ratio [OR] = 2,89), el mal control del colesterol unido a lipoproteínas de baja densidad (cLDL) (OR = 1,43) y los incrementos del índice de masa corporal (OR = 1,06) y la edad (OR = 1,02). Conclusiones. Menos de la mitad de los dislipémicos españoles asistidos en atención primaria tiene bien controlada la presión arterial. El mal control tensional se asocia especialmente con el aumento del riesgo cardiovascular y el mal control del cLDL (AU)

Background and objectives. Despite the well-known significant relationship between blood pressure and cardiovascular mortality, few data are available on the blood pressure characteristics of dyslipidemic patients. The aims of this study were to determine the blood pressure characteristics of dyslipidemic patients being treated in primary care, and to identify factors associated with poor blood pressure control. Methods. This multicentre cross-sectional study involved patients of both sexes aged ≥18 years who were diagnosed with dyslipidemia (i.e., hypercholesterolemia, hypertriglyceridemia, mixed dyslipidemia, or a low high-density lipoprotein cholesterol level) in the 17 Spanish autonomous regions. Blood pressure was measured according to standard procedures, and was considered well-controlled if it was <140/90 mm Hg (or <130/80 mm Hg in patients with diabetes, nephropathy or cardiovascular disease). Results. In total, 7054 patients were studied (mean age 61.3 [11.2] years, 50.8% male). Mean systolic and diastolic blood pressures were 134.6 [14.2]/79.8 [8.9] mm Hg, with significant differences (P<.001) between hypertensives (140.8 [14.6]/82.8 [9.0] mmHg) and normotensives (128.5 [10.7]/76.9 [7.7] mm Hg). Good blood pressure control was observed in 47.4% (95% confidence interval, 46.3­48.5%) of subjects overall, in 29.3% of hypertensives, and in 12.8% of hypertensive diabetics. Poor control was associated with an increased cardiovascular disease risk (hazard ratio [HR]=2.89), poor control of low-density lipoprotein cholesterol (HR=1.43), a higher body mass index (HR=1.06), and older age (HR=1.02). Conclusions. Fewer than half of dyslipidemic primary-care patients in Spain had good blood pressure control. Poor control was associated, in particular, with increased cardiovascular risk and poor control of the low-density lipoprotein cholesterol level (AU)

Grado de control de la dislipemia en los pacientes españoles asistidos en atención primaria. Estudio LIPICAP / Control rates of dyslipidemia in Spanish patients assisted in primary care. LIPICAP Study

Introducción. Se dispone de escasa información sobre el control de la dislipemia en España. Los objetivos de este estudio fueron conocer el grado de control de los pacientes dislipémicos asistidos en atención primaria e investigar su riesgo cardiovascular y los factores que se asocian al mal control. Pacientes y método. Estudio transversal multicéntrico que analizó en las 17 comunidades autónomas españolas a individuos de 18 o más años de ambos sexos con dislipemia (hipercolesterolemia, hipertrigliceridemia, dislipemia mixta o colesterol de las lipoproteínas de alta densidad [cHDL] bajo). Se consideró buen control el hallazgo de colesterol de las lipoproteínas de baja densidad [cLDL] < 160 mg/dl si el riesgo cardiovascular era bajo, < 130 mg/dl si era moderado y < 100 mg/dl si era alto (Adult Treatment Panel III [ATPIII]). Resultados. Se incluyó a 7.054 pacientes (media ± desviación estándar de edad, 61,3 ± 11,2 años; varones, 50,8%). El 40,3% presentó riesgo cardiovascular alto; el 28,6%, moderado, y el 31,1%, bajo. Se halló buen control en el 32,3% (intervalo de confianza del 95%, 31,2-33,4) de la población (el 57,0% de los pacientes con riesgo cardiovascular bajo, el 26,3% con riesgo moderado y el 16,6% con riesgo alto). El mal control se asoció con los antecedentes personales de diabetes, nefropatía y tabaquismo y con los antecedentes familiares de enfermedad cardiovascular prematura; el buen control se asoció con el ejercicio físico (p < 0,001). Conclusiones. Una tercera parte de los pacientes incluidos en el estudio presenta buen control de la dislipemia, y 4 de cada 10 tienen riesgo cardiovascular alto. El grado de control disminuye conforme aumenta el riesgo cardiovascular. Factores de riesgo cardiovascular y enfermedades muy prevalentes en atención primaria se asocian con el mal control de la dislipemia (AU)

Introduction. Scarce information is available about the dyslipidemia control in Spain. The aims of this study were to asses the degree of control of dyslipidemic patients attended in primary care, and to investigate their cardiovascular risk and the factors associated with poor control. Patients and method. A multicentre cross-sectional study analysing dyslipidemic patients in Spain (both sex, >= 18 years) with hypercholesterolemia, hypertriglyceridemia, mixed dyslipidemia or low HDL-cholesterol. Well-controlled dyslipidemia was defined according to NCEP-ATPIII, LDL-cholesterol < 160 in low cardiovascular risk patients, < 130 in moderate, and < 100 mg/dl in high cardiovascular risk patients. Results. 7,054 patients were included (age, 61.3 ± 11.2 years; 50.8% men). 40.3% of patients presented high cardiovascular risk, 28.6% moderate risk and 31.1% low risk. 32.3% (CI 95%, 31.2-33.4) showed good control of LDL-cholesterol (57.0% in low, 26.3% in moderate, and 16.6% in high cardiovascular risk). Poor control was associated with medical history of diabetes, kidney disease and cigarette smoking, and family history of premature cardiovascular disease; optimal control was associated to physical activity (p < 0,001). Conclusions. A third of the patients included in the study achieve target control of dyslipidemia. Four out of 10 present high cardiovascular risk. The control degree decreases as cardiovascular risk increases. Cardiovascular risk factors and very prevalent diseases in Primary Care are associated with a poor control of dyslipidemia (AU)