Prevalence of hypercholesterolemia and statins intake in the outpatient practice in the Russian Federation (ICEBERG study)
Keywords:
hypercholesterolemia, outpatients, total cholesterol, cardiovascular risk, rosuvastatin, statinsAbstract
Aim. To estimate the prevalence of primary hypercholesterolemia at the outpatient level and the frequency of prescribing statins with the achievement of the target level of total cholesterol (TC) in various districts of the Russian Federation.
Material and methods. The study involved persons over 30 years old who referred to general practitioners or cardiologists for various reasons within one month of 2016. The measurement of TC level was performed using a portable photometric blood analyzer. A standard survey was conducted for each participant, including an assessment of the atherosclerosis risk factors, cardiovascular disease presence, and SCORE risk stratification.
Results. The final analysis included 18489 patients (60% of women, mean age 60 years). A high incidence of hypertension (90%) and hypercholesterolemia (84%) was noted, with an average TC level of 6.2 mmol/L. The incidence of severe hypercholesterolemia (> 8 mmol/L) was 5.6%. In 30% of cases, risk factors such as diabetes and smoking have been documented. Coronary heart disease (СHD) and its equivalents were defined in 65% of study participants. The rate of statin use is 32% and was inversely related to the cardiovascular risk category, reaching a maximum of 42% at a very high risk. The frequency of achieving a target TC level less than 4.5 and 4.0 mmol/L in patients with high and very-high risk was 5.0% and 5.7% respectively. In those with CHD, and also after a stroke, the frequency of statin use varied in the range of 50–60% with the achievement of target TC level in 4.0–11.4% of cases.
The conclusion. Regardless of the federal district of the Russian Federation, there is high prevalence of hypercholesterolemia and arterial hypertension in out-patient practice. Despite the high cardiovascular risk, only 40–60% of patients are on statins. The frequency of achieving the target level of total cholesterol in patients with cardiovascular disease is below 12%.
