Blog | Wednesday, October 17, 2012

QD: News Every Day--Cholesterol, triglycerides improving, but obesity and need for cardiovascular interventions continues


Two studies of large-scale trends in cardiovascular health and interventions showed that while Americans have healthier levels of cholesterol and triglycerides, obesity is still prevalent and the need for angioplasty and stents continues.

First, lipid levels improved from 1988 to 2010, according to trends from the National Health and Nutrition Examination Surveys, considering periods of 1988-1994, 1999-2002 and 2007-2010.

Results appeared in The Journal of the American Medical Association.
--Mean total cholesterol fell from 206 (95% confidence interval [CI], 205 to 207) mg/dL in 1988-1994 to 196 (95% CI, 195 to 198) mg/dL in 2007-2010 (P less than .001 for linear trend).
--Mean LDL-C declined from 129 (95% CI, 127 to 130) mg/dL to 116 (95% CI, 114 to 117) mg/dL (P less than .001 for linear trend).
--Mean non-HDL-C declined from 155 (95% CI, 153 to 157) mg/dL in 1988-1994 to 144 (95% CI, 143 to 145) mg/dL in 2007-2010 (P less than .001 for linear trend).
--Mean HDL-C increased from 50.7 (95% CI, 50.0 to 51.0) mg/dL during 1988-1994 to 52.5 (95% CI, 51.8 to 53.2) mg/dL in 2007-2010 (P=.001 for linear trend).
--Mean triglyceride levels increased from 118 (95% CI, 114 to 121) mg/dL in 1988 to 1994 to 123 (95% CI, 119 to 127) mg/dL in 1999-2002 and decreased to 110 (95% CI, 107-113) mg/dL in 2007-2010 (P less than .001 for quadratic trend).
--Use of lipid-lowering medications increased from 3.4% (95% CI, 2.9% to 3.9%) in 1988-1994 to 15.5% (95% CI, 14.7% to 16.3%) in 2007-2010 (P less than .001 for linear trend).

Trends in lipids were similar among adults not receiving lipid-lowering medications to those reported for adults overall. But among obese adults, mean total cholesterol, non-HDL-C, LDL-C, and mean triglycerides declined between 1988 and 2010.

Researchers noted that the trends may be due eating fewer trans-fatty acids or other lifestyle changes, as well as more adults taking lipid-lowering medications. "They are unlikely to be the result of changes in physical activity, obesity, or intake of saturated fat."

Next, a report from the CathPCI Registry, a data registry that includes information from 85% of U.S. cath labs, analyzed data from 1.1 million patients undergoing diagnostic cardiac catheterization procedures and 941,248 patients who underwent angioplasty and stenting from Jan. 1, 2010, through June 30, 2011.

Results appeared in The Journal of the American College of Cardiology.
--Almost 80% of angioplasty and stent patients were overweight, including 43% who were obese. Other prevalent risk factors were 80% with high cholesterol and 82% with high blood pressure.
--Almost 28% of patients who underwent PCI were current or recent smokers.
--Among the patients undergoing angioplasty and stenting, 70% presented with heart attack or other acute symptoms, while approximately 18% had stable angina and 12% had atypical symptoms or no angina.

"The value of the CathPCI Registry will be demonstrated as it is used to understand further the practice of invasive cardiology and to drive a higher level of quality into individual physician practice," the researchers wrote.