scholarly journals The role of different lipid measures for incident hypertension during more than 12 years follow-up: Tehran Lipid and Glucose Study

2021 ◽  
pp. 1-32
Author(s):  
Amirreza Hadaegh ◽  
Samaneh Akbarpour ◽  
Maryam Tohidi ◽  
Niloofar Barzegar ◽  
Somayeh Hosseinpour-Niazi ◽  
...  
Keyword(s):  
Drug Users ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Continuous Variables ◽  
Incident Hypertension ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Regression ◽  
Lowering Drug

Abstract To examine the associations of different lipid measures and related indices with incident hypertension during a median follow-up of 12.89 years. Fasting levels of total cholesterol (TC), triglycerides (TG), high and low density lipoprotein cholesterol (HDL-C and LDL-C, respectively), and related indices (TC/HDL-C and TG/HDL-C) were determined in 7335 Iranian adults (men=3270) free of hypertension, aged 39.0 [standard deviation (SD):13.2] years. Multivariate Cox proportional hazard regression was applied and lipid parameters were considered either as categorical or continuous variables. During follow-up, 2413 (men=11260) participants experienced hypertension. Using the first quartile as reference, significant trends were found between quartiles of TG, HDL-C, TC/HDL-C, and TG/HDL-C in multivariate models; moreover considering these measures as continuous variables, a 1 SD increase in each of these parameters was significantly associated with risk of incident hypertension; the corresponding hazard ratios and confidence intervals were 1.06(1.02-1.10), 0.94(0.89-0.98), 1.04(1.01-1.09), and 1.04(1.01-1.07), respectively. The association between lipid measures and incident hypertension did not change after excluding lipid lowering drug users and those with type 2 diabetes mellitus and were independent of the baseline categories of blood pressure (P for interaction > 0.08). To take into account the nutrition data, a re-analysis on a subgroup (n=1705), showed that a 1-SD increase in TG and TG/HDL-C were associated with incident hypertension, after adjusting for dietary cofounders [1.15(1.08–1.24) and 1.03(1.01–1.04), respectively]. These findings indicate that TG, TG/HDL-C, and TC/HDL-C were independently associated with higher risk while HDL-C was associated with lower risk of incident hypertension.

scholarly journals Low-density lipoprotein cholesterol and risk of intracerebral hemorrhage

Neurology ◽  
2019 ◽  
Vol 93 (5) ◽  
pp. e445-e457 ◽  
Author(s):  
Chaoran Ma ◽  
M. Edip Gurol ◽  
Zhe Huang ◽  
Alice H. Lichtenstein ◽  
Xiuyan Wang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Low Density ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Ideal

ObjectiveTo prospectively examine the association between low-density lipoprotein (LDL) cholesterol (LDL-C) concentrations and intracerebral hemorrhage (ICH) risk.MethodsThe current cohort study included 96,043 participants (mean age 51.3 years) who were free of stroke, myocardial infarction, and cancer at baseline (2006). Serum LDL-C concentrations were assessed in 2006, 2008, 2010, and 2012. Cumulative average LDL-C concentrations were calculated from all available LDL-C data during that period. Incident ICH was confirmed by review of medical records.ResultsWe identified 753 incident ICH cases during 9 years of follow-up. The ICH risk was similar among participants with LDL concentrations of 70 to 99 mg/dL and those with LDL-C concentrations ≥100 mg/dL. In contrast, participants with LDL-C concentrations <70 mg/dL had a significantly higher risk of developing ICH than those with LDL-C concentrations of 70 to 99 mg/dL; adjusted hazard ratios were 1.65 (95% confidence interval [CI] 1.32–2.05) for LDL-C concentrations of 50 to 69 mg/dL and 2.69 (95% CI 2.03–3.57) for LDL-C concentrations <50 mg/dL.ConclusionsWe observed a significant association between lower LDL-C and higher risk of ICH when LDL-C was <70 mg/dL, and the association became nonsignificant when LDL-C ≥70 mg/dL. These data can help determination of the ideal LDL range in patients who are at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies.

scholarly journals The Impact of Changes in Population LDL-C Levels on LDL-C Control in Patients After PCI in China: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Huan Liu ◽  
Zhipeng Zhou ◽  
Yanqing Wu ◽  
Jingsong Xu
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Blood Lipid ◽  
Coronary Intervention ◽  
Lifestyle Changes ◽  
Treatment Goal ◽  
Lipid Lowering ◽  
Lipid Control ◽  
The Impact

Abstract BANKGROUND: Mortality from coronary artery disease continues to rise, and secondary prevention and treatment are particularly important. OBJECTIVE: The objective of this study is to evaluate low-density lipoprotein cholesterol (LDL-C) levels in patients after percutaneous coronary intervention (PCI), to describe how treatment outcomes for individual patients changed over time and to examine the potential impact of lipid control rates through population LDL-C levels changes.METHODS: This retrospective study was conducted in patients who underwent PCI between July 2017 and June 2019. The main results included LDL-C levels after PCI. To assess the outcome of prevention, three separate measures of LDL-C were considered: baseline, first follow-up, and final follow-up, and LDL-C control rates were analyzed according to different guidelines. we examine the impact of 0.1mmol/l decreases or increases in population LDL-C levels on LDL-C control.RESULTS: Data were analyzed for 423 patients (mean age, 62 ±10 years), and the baseline LDL-C level was 3.11 ± 0.99 mmol/l. 51.5% of the patients achieved the Chinese Lipids Guidelines treatment goal, 22% and 11.6% of the patients achieved the 2016 ESC Lipids Guidelines and 2019 ESC Lipids Guidelines treatment goal at the final follow-up period respectively. LDL-C levels fluctuated during the follow-up period, and the long-term maintenance results could not be guaranteed after PCI. Population LDL-C levels changes in lifestyle could have a very large impact on LDL-C control in China.CONCLUSION: LDL-C control with statins is not ideal in patients after PCI, which is far from the requirements of the latest guidelines. Although clinicians understand the lipid-lowering effect of statins, they should not give up active lifestyle changes, and should strengthen the comprehensive management of blood lipid control.

Abstract P43: Frequency and Predictors of Low-Density Lipoprotein Cholesterol Control and Appropriate Response to Elevated LDL-C Levels in Patients with Cardiovascular Disease

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Salim S Virani ◽  
Lechauncy D Woodard ◽  
Supicha Sookanan ◽  
Cassie R Landrum ◽  
Tracy H Urech ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Low Density Lipoprotein ◽  
Medication Possession Ratio ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
To Receive

Background: Although current cholesterol performance measures define good quality as low density lipoprotein cholesterol (LDL-C) levels < 100mg/dl in cardiovascular disease (CVD) patients, they provide a snap shot at one time point and do not inform whether an appropriate action was taken to manage elevated LDL-C levels. We assessed frequency and predictors of this appropriate response (AR). Methods: We used administrative data to assess 22,902 CVD patients receiving care in a Veterans Affairs network of 7 hospitals and affiliated clinics. We determined the proportion of CVD patients at LDL-C goal <100 mg/dl, and the proportion of patients with uncontrolled LDL-C levels (>100 mg/dl) who had an AR [defined as the initiation or dosage increase of a lipid lowering medication (LLM), addition of a new LLM, receipt of maximum dosage or >1 LLM, or LDL-C reading <100 mg/dl] at 45 days follow-up. Logistic regression was performed to evaluate facility, provider and patient characteristics associated with AR. Results: LDL-C levels were at goal in 16,350 (71.4%) patients. An additional 2,110 (9.2%) had an AR at 45 days of follow-up. Controlling for clustering between facilities and patient's illness severity, history of diabetes (OR 1.18, 95% CI 1.03-1.35), hypertension (OR 1.21, 95% CI 1.02-1.44), patients showing good medication adherence (medication possession ratio > 0.8) [OR 2.29, 95% CI 1.99-2.64] were associated with AR. Older CVD patients (age >75 years) were less likely to receive AR (OR 0.60, 95% CI 0.52-0.70). Teaching vs. non-teaching facility (p=0.40), physician vs. non-physician provider (p=0.14), specialist vs. non-specialist primary care provider (p=0.12), and patient's race (p=0.12) were not predictors of AR. Conclusion: Among patients with CVD and LDL-C above guideline recommended levels, only one-third receive AR. Diabetic and hypertensive CVD patients are more likely to receive AR, whereas older Veterans with CVD receive AR less often likely reflecting providers' belief of lack of efficacy from treatment intensification in older CVD patients. Our findings are important for quality improvement and policy making initiatives as they provide more actionable information compared with isolated LDL-C goal attainment as a quality indicator.

Secondary prevention care and effect: Total and low-density lipoprotein cholesterol levels and lipid-lowering drug use in women and men after incident myocardial infarction – The Tromsø Study 1994–2016

2018 ◽  
Vol 17 (6) ◽  
pp. 563-570 ◽  
Author(s):  
Laila A Hopstock ◽  
Anne Elise Eggen ◽  
Maja-Lisa Løchen ◽  
Ellisiv B Mathiesen ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Low Density ◽  
Lipid Levels ◽  
Treatment Target ◽  
Cholesterol Levels ◽  
Lipid Lowering Drug ◽  
Lowering Drug

Background: Secondary prevention guidelines after myocardial infarction (MI) are gender neutral, but underutilisation of treatment in women has been reported. Design: We investigated the change in total and low-density lipoprotein (LDL) cholesterol levels and lipid-lowering drug (LLD) use after first-ever MI in a population-based study. Methods: We followed 10,005 participants (54% women) attending the Tromsø Study 1994–1995 and 8483 participants (55% women) attending the Tromsø Study 2007–2008 for first-ever MI up to their participation in 2007–2008 and 2015–2016, respectively. We used linear and logistic regression models to investigate sex differences in change in lipid levels. Results: A total of 395 (MI cohort I) and 132 participants (MI cohort II) had a first-ever MI during 1994–2008 and 2007–2013, respectively. Mean change in total cholesterol was −2.34 mmol/L (SD 1.15) in MI cohort I, and in LDL cholesterol was −1.63 mmol/L (SD 1.12) in MI cohort II. Men had a larger decrease in lipid levels compared to women: the linear regression coefficient for change was −0.33 (95% confidence interval [CI] −0.51 to −0.14) for total cholesterol and −0.21 (95% CI −0.37 to −0.04) for LDL cholesterol, adjusted for baseline lipid value, age and cohort. Men had 73% higher odds (95% CI 1.15−2.61) of treatment target achievement compared to women, adjusted for baseline lipid value, age and cohort. LLD use was reported in 85% of women and 92% of men in MI cohort I, and 80% in women and 89% in men in MI cohort II. Conclusions: Compared to men, women had significantly less decrease in lipid levels after MI, and a smaller proportion of women achieved the treatment target.

scholarly journals Effect of Cholecystectomy on Serum Lipids and Blood Glucose (Hospital Based Observational Prospective Study)

2021 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Om Karki ◽  
Bishow Deep Timilsina
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Lipid Profile ◽  
Glucose Level ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Atherogenic Index ◽  
Lipid Lowering ◽  
Lowering Drug

Introduction: Association between cholelithiasis and dyslipidemia has been shown in many studies. Recent studies have shown improvement in lipid profile following cholecystectomy. This study aimed to determine the changes in lipid profile and blood glucose level after cholecystectomy.Methods: Seventy-three patients of cholelithiasis were studied prospectively. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), atherogenic index (AI) and fasting blood sugar (FBS) levels were estimated pre-operatively. Further, the same parameters were studied after cholecystectomy after one week and one-month intervals. None of the patients received any lipid-lowering drug or dietary restriction. Results were analysed and compared.Results: Of the 73 patients with cholelithiasis, 66% were female and 34% male. The mean age of patients was 40.53± 13.16 years. 56% of patients with cholelithiasis had a deranged lipid profile. TC was significantly decreased at one week (p=0.002) and one month (p=0.00) interval after cholecystectomy while TG levels also decreased significantly at one month postoperative (p=0.001). There were no significant differences in LDL-c however improvement was seen on HDL-c. Blood glucose level also increased significantly (p=0.028) after one month of cholecystectomy.Conclusion: Cholelithiasis is associated with an abnormal lipid profile. Cholecystectomy leads to a significant decrease in some of the parameters of lipid profile and the atherogenic index. The presence of gall stones thus should be perceived in the context of metabolic syndrome, which may be investigated and treated.

scholarly journals Contribution of Nontraditional Lipid Profiles to Hyperuricemia in Rural Chinese Hypertensive Population: Findings From the China Hypertension Registry Study

2020 ◽  
Author(s):  
Yu Yu ◽  
Tian Lan ◽  
Dandan Wang ◽  
Wangsheng Fang ◽  
Yu Tao ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Multivariate Logistic Regression Analysis ◽  
Density Lipoprotein ◽  
Smooth Curve ◽  
Lipid Profiles ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Continuous Variables ◽  
Hypertensive Population ◽  
The Relationship

Abstract Background: Current studies support nontraditional lipid profiles [total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) ratio, triglyceride (TG)/HDL-C ratio, low-density lipoprotein cholesterol (LDL -C)/HDL-C ratio, non-HDL-C] as reliable indicators of cardiovascular disease, stroke and diabetes. However, whether nontraditional lipid profiles can be used as reliable markers for hyperuricemia (HUA) remains unclear due to limited research. The present study investigated the relationship of nontraditional lipid profiles with HUA in hypertensive patients.Methods: We analyzed data from 13,721 Chinese hypertensive population untreated with lipid-lowering drugs. The relationship between non-traditional lipid profiles and HUA was examined by multivariate logistic regression analysis and smooth curve fitting (penalized spline method).Results: The results showed that there were positive associations of TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C with HUA, respectively (all P <0.001). Furthermore, nontraditional lipid profiles were converted from continuous variables to tertiles. Compared with lowest tertile, the multivariate adjusted ORs (95% CI) of TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio and non-HDL-C in highest tertile were 1.79 (1.62, 1.99), 2.09 (1.88, 2.32), 1.67 (1.51, 1.86), 1.93 (1.74, 2.13), respectively (all P <0.001).Conclusions: In Chinese hypertensive population, there were positive associations between nontraditional lipid profiles (TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio, and non-HDL-C) and HUA. Our findings further expand the scope of application of nontraditional lipid profiles. These novel and important results suggest that nontraditional lipid profiles can be used as potential and valuable indicators of HUA, and provide a new strategy for the prevention and treatment of HUA.

The role of bempedoic acid in the management of dyslipidaemia

2021 ◽  
Vol 3 (12) ◽  
pp. 484-488
Author(s):  
Beverley Bostock
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Technology Appraisal ◽  
The United Kingdom ◽  
Lipid Lowering Drug ◽  
Lowering Therapy ◽  
Lowering Drug

Bempedoic acid is a new oral lipid-lowering therapy which has been licenced for use in the United Kingdom. It can be used alone, with a statin, or with other lipid-lowering therapies where the target level for low density lipoprotein has not been achieved with these therapies alone. Bempedoic acid with ezetimibe can be prescribed for people who are unable to tolerate statins. This combination has received NICE approval following a technology appraisal. This paper discusses the place for of bempedoic acid as a lipid lowering drug and consider the mode of action, licensed indications, adverse drug reactions and the NICE technology appraisal recommendations.

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