Medication adherence, cascade screening, and lifestyle patterns among women with hypercholesterolemia: Results from the WomenHeart survey
Medication adherence, cascade screening, and lifestyle patterns among women with hypercholesterolemia: Results from the WomenHeart survey
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DOI：
10.1016/j.jacl.2016.03.012
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发表时间：
2016-08-01
影响因子：
4.4
通讯作者：
Gulati, Martha
中科院分区：
文献类型：
--
作者：
Benson, Gretchen;Witt, Dawn R.;Gulati, Martha
背景：高胆固醇血症是心血管疾病的主要危险因素。患有高胆固醇血症和家族性高胆固醇血症（FH）的女性是一个高风险群体，经常被诊断、治疗不足，并且没有意识到需要进行级联筛查。目的：目的是在2个国家数据库中确定高胆固醇血症和FH的患病率，探索生活方式/药物依从性，并检查FH患者的级联筛查（所有一级亲属的脂质检测）率。方法：这是一项对2014年完成在线调查的女性进行的横断面研究。结果检查了3组：确诊、可能和无FH。对于FH，采用多变量logistic回归来检验家庭成员FH筛查与社会人口统计学和/或临床特征之间的关系。结果：调查对象761人，平均（标准差）年龄59 +/- 10.1岁；26%报告有FH， 22%可能有FH， 51%没有FH。83%的总样本和95%的FH患者服用他汀类药物。在高胆固醇血症和FH患者中，分别有65%和58%的人报告高药物依从性。可能患有FH的女性食用的水果/蔬菜明显减少，运动也较少。FH级联筛查为：兄弟姐妹54%，父母37%，儿童34%。婚姻状况、家庭年收入和糖尿病与级联筛查显著相关。结论：在一项对知情的高胆固醇血症和FH妇女的调查中，级联筛查未得到充分利用。我们的研究结果证明需要加大努力来识别级联筛选障碍。早期发现和治疗高胆固醇血症/FH是妇女及其一级亲属的优先事项，因为这可能大大减少心血管疾病的影响。(C) 2016年全国血脂协会。版权所有。
BACKGROUND: Hypercholesterolemia is a major risk factor for cardiovascular disease. Women with hypercholesterolemia and familial hypercholesterolemia (FH) are a high-risk group often under diagnosed, undertreated, and unaware of the need for cascade screening.OBJECTIVES: The objectives were to identify the prevalence of hypercholesterolemia and FH in 2 national databases, explore lifestyle/medication adherence, and examine rates of cascade screening (lipid testing in all first-degree relatives) among those with FH.METHODS: This was a cross-sectional study of women who completed an online survey in 2014. Outcomes were examined for 3 groups: diagnosed, probable, and no FH. For FH, multivariable logistic regression was used to examine the association between family member screening for FH and socio-demographic and/or clinical characteristics.RESULTS: There were 761 respondents with a mean ( standard deviation) age of 59 +/- 10.1 years; 26% reported FH, 22% probable FH, and 51% no FH. Eighty-three percent of the total sample and 95% with FH take a statin. In those with hypercholesterolemia and FH, 65% and 58% reported high medication adherence, respectively. Women with probable FH consumed significantly fewer fruits/vegetables and were less active. FH cascade screening was: siblings 54%, parents 37%, and children 34%. Marital status, annual household income, and diabetes were significantly associated with cascade screening.CONCLUSION: In a survey of informed women with hypercholesterolemia and FH, cascade screening is underused. Our findings warrant increased efforts to identify cascade screening barriers. Early detection and treatment of hypercholesterolemia/FH is a priority for women, and their first degree relatives, as this may dramatically reduce cardiovascular disease impact. (C) 2016 National Lipid Association. All rights reserved.