Prevalence and Patient Outcomes of Adult Primary Hypercholesterolemia and Dyslipidemia in the UK: Longitudinal Retrospective Study Using a Primary Care Dataset from 2009 to 2019.
NICE guidelines
atherosclerosis
cardiovascular disease
lipid management
Journal
ClinicoEconomics and outcomes research : CEOR
ISSN: 1178-6981
Titre abrégé: Clinicoecon Outcomes Res
Pays: New Zealand
ID NLM: 101560564
Informations de publication
Date de publication:
2022
2022
Historique:
received:
05
11
2021
accepted:
10
03
2022
entrez:
12
4
2022
pubmed:
13
4
2022
medline:
13
4
2022
Statut:
epublish
Résumé
Guidelines for the management of dyslipidemias recommend intensive low-density lipoprotein (LDL-C) control through lifestyle advice and lipid-lowering drugs to reduce the risk of cardiovascular disease (CVD). This retrospective study aimed to characterize the adult primary care population with primary hypercholesterolemia (PH)/mixed dyslipidemia (MD). Data on adults with PH/MD between 1 January 2009 and 31 December 2019 in the UK were extracted from linked primary Clinical Practice Research Datalink (CPRD) and secondary care (Hospital Episode Statistics) datasets and analyzed. A total of 279,221 patients met the inclusion criteria. Mean follow-up was 8.6 years. Crude prevalence of PH/MD increased from 13.5% in 2009 to 23.5% by 2019. The incidence decreased from 176 to 49 per 100,000 population. Mean age of the cohort was 58 years, baseline LDL-C was 4.32 mmol/L, 19.6% had atherosclerotic CVD, 30.1% diabetes, and 8.5% heterozygous familial hypercholesterolemia. Estimated LDL-C reductions of 40% and 50% were achieved in 2.6% and 2.3% of patients, respectively. Most received moderate-intensity statins as monotherapy (62.4%); high-intensity statins were used less frequently (24.3% as initial treatment). Less than 10% of patients received ezetimibe plus statins of different intensities. The prevalence of dyslipidemia doubled between 2009 and 2019, likely due to more systematic identification of PH/MD. A large proportion of patients with PH/MD are of high and very high CV risk, remain suboptimally treated in terms of lipid lowering, and may experience CV events with associated non-negligible clinical and economic sequelae. Despite intensive LDL-C-lowering recommendations, these do not translate in clinical practice to the wider population.
Sections du résumé
Background
UNASSIGNED
Guidelines for the management of dyslipidemias recommend intensive low-density lipoprotein (LDL-C) control through lifestyle advice and lipid-lowering drugs to reduce the risk of cardiovascular disease (CVD).
Objective
UNASSIGNED
This retrospective study aimed to characterize the adult primary care population with primary hypercholesterolemia (PH)/mixed dyslipidemia (MD).
Methods
UNASSIGNED
Data on adults with PH/MD between 1 January 2009 and 31 December 2019 in the UK were extracted from linked primary Clinical Practice Research Datalink (CPRD) and secondary care (Hospital Episode Statistics) datasets and analyzed.
Results
UNASSIGNED
A total of 279,221 patients met the inclusion criteria. Mean follow-up was 8.6 years. Crude prevalence of PH/MD increased from 13.5% in 2009 to 23.5% by 2019. The incidence decreased from 176 to 49 per 100,000 population. Mean age of the cohort was 58 years, baseline LDL-C was 4.32 mmol/L, 19.6% had atherosclerotic CVD, 30.1% diabetes, and 8.5% heterozygous familial hypercholesterolemia. Estimated LDL-C reductions of 40% and 50% were achieved in 2.6% and 2.3% of patients, respectively. Most received moderate-intensity statins as monotherapy (62.4%); high-intensity statins were used less frequently (24.3% as initial treatment). Less than 10% of patients received ezetimibe plus statins of different intensities.
Conclusion
UNASSIGNED
The prevalence of dyslipidemia doubled between 2009 and 2019, likely due to more systematic identification of PH/MD. A large proportion of patients with PH/MD are of high and very high CV risk, remain suboptimally treated in terms of lipid lowering, and may experience CV events with associated non-negligible clinical and economic sequelae. Despite intensive LDL-C-lowering recommendations, these do not translate in clinical practice to the wider population.
Identifiants
pubmed: 35411162
doi: 10.2147/CEOR.S347085
pii: 347085
pmc: PMC8994561
doi:
Types de publication
Journal Article
Langues
eng
Pagination
189-203Informations de copyright
© 2022 Bilitou et al.
Déclaration de conflit d'intérêts
Dr Aikaterini Bilitou and Dr Inaam Haq are employees of Daiichi Sankyo Europe GmbH. Kyle Dunton is an employee of Daiichi Sankyo UK. At the time of the study and manuscript preparation, John Were, Archie Farrer, Dr Simon Wan Yau Ming, and Dr Adrian Rabe were employees of Health iQ Ltd. Dr Adrian Rabe was also an honorary research fellow at Imperial College London. The authors report no other conflicts of interest in this work.
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