Uptake and detection rate of a stepwise cardiometabolic disease detection program in primary care-a cohort study

Prevalence of dyslipidemia and hypercholesterolemia awareness: results from the Lookup 7+ online project

Background

Cardiovascular disease still represents the leading cause of death worldwide. Management of risk factors remains crucial; despite this, hypercholesterolemia, which is one of the most important modifiable cardiovascular risk factor, is still high prevalent in general population. The aim of this study is to determine the prevalence of dyslipidemia and hypercholesterolemia awareness in a very large population.

Methods

More than 65 000 users completed the online, self-administered survey. It was structured like a ‘journey’ where each stage corresponded to a cardiovascular risk factor: blood pressure, body mass index, cholesterol, diet, physical exercise, smoke and blood sugar. At the end, the user received a final evaluation of his health status.

Results

The mean age was 52.5 years (SD 13.9, range 18–98), with 35 402 (53.7%) men. About 56% of all participants believed to have normal cholesterol values, when only 40% of them really showed values <200 mg/dl. Only about 30% of all participants self-predicted to have abnormal cholesterol values whereas we found high cholesterol levels in about 60% of people.

Conclusions

Dyslipidemia is very prevalent and half of the people with high cholesterol is not aware of having high values.

Blood pressure and cholesterol measurements in primary care: cross-sectional analyses in a dynamic cohort

Background

Guidelines on cardiovascular risk management (CVRM) recommend blood pressure (BP) and cholesterol measurements every 5 years in men aged ≥40 years and (post-menopausal) women aged ≥50 years.

Aim

To evaluate CVRM guideline implementation.

Design & setting

Cross-sectional analyses in a dynamic cohort using primary care electronic health record (EHR) data from the Julius General Practitioners’ Network (JGPN) (n = 388 929).

Method

Trends (2008–2018) were assessed in the proportion of patients with at least one measurement (BP and cholesterol) every 1, 2, and 5 years, in those with:

1. a history of cardiovascular disease (CVD) and diabetes mellitus (DM);

2. a history of DM only;

3. a history of CVD only;

4. a cardiovascular risk assessment (CRA) indication based on other medical history, or;

5. no CRA indication.

Trends were evaluated over time using logistic regression mixed-model analyses.

Results

Trends in annual BP and cholesterol measurement increased for patients with a history of CVD from 37.0% to 48.4% (P<0.001) and 25.8% to 40.2% (P<0.001). In the 5-year window from 2014–2018, BP and cholesterol measurements were performed respectively in 78.5% and 74.1% of all men aged ≥40 years and 82.2% and 78.5% of all women aged ≥50 years. Least measured were patients without a CRA indication (men 60.2% and 62.4%; women 55.5% and 59.3%).

Conclusion

The fairly high frequency of CVRM measurements available in the EHR of patients in primary care suggests an adequate implementation of the CVRM guideline. As nearly all individuals visit the GP at least once within a 5-year time window, improvement of CVRM remains possible, especially in those without a CRA indication.