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.
Labels: cardiology, cardiovascular risk, cholesterol, hyperlipidemia, lifestyle, prevention, QD
posted by Ryan DuBosar at
7:00 AM
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Albert Fuchs, MD, FACP, graduated from the
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Zackary Berger, MD, ACP Member, is a primary care doctor and
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Controversies in Hospital
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Run by three ACP
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Robert M. Centor, MD, FACP, contributes short essays contemplating
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DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about
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Matthew Mintz, MD, FACP, has practiced internal medicine for more
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Everything
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Toni Brayer, MD, FACP, blogs about the rapid changes in science,
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FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the
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Ryan Madanick, MD, ACP Member, is a gastroenterologist at the
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Mike Aref, MD, PhD, FACP, is an academic hospitalist with an
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David L. Katz, MD, MPH, FACP, is an internationally renowned
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Richard Just, MD, ACP Member, has 36 years in clinical practice of
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Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites
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Michael Kirsch, MD, FACP, addresses the joys and challenges of
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Elaine Schattner, MD, FACP, shares her ideas on education, ethics
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Mired in MedEd
Alexander M.
Djuricich, MD, FACP, is the Associate Dean for Continuing Medical
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blogs about medical education.
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Rob Lamberts, MD, ACP Member, a med-peds and general practice
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David M. Sack, MD, FACP, practices general gastroenterology at a
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Reflections of a Grady
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Kimberly Manning, MD, FACP, reflects on the personal side of being
a doctor in a community hospital in Atlanta.
The Blog of Paul Sufka
Paul Sufka,
MD, ACP Member, is a board certified rheumatologist in St. Paul,
Minn. He was a chief resident in internal medicine with the
University of Minnesota and then completed his fellowship training
in rheumatology in June 2011 at the University of Minnesota
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Technology in (Medical)
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Neil Mehta, MBBS, MS, FACP, is interested in use of technology in
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Peter A. Lipson,
MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and
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around in various forms since 2007, offers musings on the
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Why is American Health Care So Expensive?
Janice
Boughton, MD, FACP, practiced internal medicine for 20 years before
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World's Best Site
Daniel Ginsberg, MD,
FACP, is an internal medicine physician who has avidly applied
computers to medicine since 1986, when he first wrote medically
oriented computer programs. He is in practice in Tacoma,
Washington.
Other blogs of note:
American Journal of
Medicine
Also known as the Green Journal, the American Journal of Medicine
publishes original clinical articles of interest to physicians in
internal medicine and its subspecialities, both in academia and
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Clinical
Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP
Member, associate program director at New York University Medical
Center's internal medicine residency program. Faculty, residents
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Interact MD
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he can create an independent, clinician-reviewed space on the
Internet for physicians to report and comment on the medical news
of the day.
PLoS Blog
The Public Library of Science's open access materials include a
blog.
White Coat
Rants
One of the most popular anonymous blogs written by an emergency
room physician.
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