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Research article
Aapo Tahkola
University of Eastern Finland
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8365-1129
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control.
Methods
In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting.
Results
More than half (54% of women and 53 % of men) of untreated patients did not meet the LDL-C target of <3 mmol/l and one third (35% of women and 33 % of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p<0.001) and lower LDL-C level (p<0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p<0.001). In total, about half of the patients were on LLM (53% of women and 51 % of men).
Conclusions
Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.
Keywords
Dyslipidemia, Hypertension, Lifetime risk, Lipid-lowering medication, LDL-C, Target
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Primary Care.
No community comments so far
Editorial decision: Accept
On 03 Apr, 2020
Review #1 received
Received 18 Mar, 2020
Reviewers invited
Invitations sent on 05 Mar, 2020
Reviewer #1 agreed
On 05 Mar, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
Version 1
Posted 30 Sep, 2019
No comments provided
Editorial decision: Major revision
On 09 Jan, 2020
Review #2 received
Received 01 Jan, 2020
Reviewer #2 agreed
On 17 Dec, 2019
Review #1 received
Received 17 Oct, 2019
Reviewer #1 agreed
On 30 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 24 Sep, 2019
Editor assigned
On 24 Sep, 2019
Editor invited
On 23 Sep, 2019
First submitted
On 20 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Practice
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Primary Care.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Aapo Tahkola
University of Eastern Finland
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8365-1129
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Primary Care.
No community comments so far
Editorial decision: Accept
On 03 Apr, 2020
Review #1 received
Received 18 Mar, 2020
Reviewers invited
Invitations sent on 05 Mar, 2020
Reviewer #1 agreed
On 05 Mar, 2020
Editor assigned
On 10 Feb, 2020
Submission checks complete
On 09 Feb, 2020
Editor invited
On 09 Feb, 2020
Version 1
Posted 30 Sep, 2019
No comments provided
Editorial decision: Major revision
On 09 Jan, 2020
Review #2 received
Received 01 Jan, 2020
Reviewer #2 agreed
On 17 Dec, 2019
Review #1 received
Received 17 Oct, 2019
Reviewer #1 agreed
On 30 Sep, 2019
Reviewers invited
Invitations sent on 26 Sep, 2019
Submission checks complete
On 24 Sep, 2019
Editor assigned
On 24 Sep, 2019
Editor invited
On 23 Sep, 2019
First submitted
On 20 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
General Practice
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Primary Care.
Background
In hypertensive patients, reducing plasma low-density lipoprotein cholesterol level (LDL-C) is one of the main interventions for preventing chronic cardiovascular diseases (CVD). However, LDL-C control remains generally insufficient, also in patients with hypertension. We analyzed Electronic Health Record (EHR) data of 7117 hypertensive patients to find the most potential subgroups in greatest need for improvement in real life dyslipidemia treatment. Taking into account the current discussion on lifetime CVD risk, we focused on the age dependence in LDL-C control.
Methods
In this observational cross-sectional study, based on routine electronic health record (EHR) data, we investigated LDL-C control of hypertensive, non-diabetic patients without renal dysfunction or CVD, aged 30 years or more in Finnish primary care setting.
Results
More than half (54% of women and 53 % of men) of untreated patients did not meet the LDL-C target of <3 mmol/l and one third (35% of women and 33 % of men) of patients did not reach the target even with the lipid-lowering medication (LLM). Furthermore, higher age was strongly associated with better LDL-C control (p<0.001) and lower LDL-C level (p<0.001) in individuals with and without LLM. Higher age was also strongly associated with LLM prescription (p<0.001). In total, about half of the patients were on LLM (53% of women and 51 % of men).
Conclusions
Our findings indicate that dyslipidemia treatment among Finnish primary care hypertensive patients is generally insufficient, particularly in younger age groups who might benefit the most from CVD risk reduction over time. Clinicians should probably rely more on the lifetime risk of CVD, especially when treating working age hypertensive patients.
Figure 1
Figure 2
Figure 3
Figure 4
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