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【medical-news】胆固醇的理想值与实际值之间距离
An estimated 63 million adults have low-density lipoprotein cholesterol (LDL-C) levels higher than what would be ideal as recommended by the National Institutes of Health.
Of that group, 38 million are people with health conditions that put them at increased risk for cardiovascular disease.
These findings, by Stephen D. Persell and co-researchers at Northwestern University Feinberg School of Medicine, are reported in the February issue of the Journal of General Internal Medicine. Persell, who led the study, is assistant professor of medicine at the Feinberg School.
The study, which compared 2001 NIH cholesterol level targets with revised, more stringent, optimal targets issued in 2004, found that 10 million more adults had LDL-C ("bad cholesterol") levels above the new targets.
The new guidelines recommend that physicians strive to get patients' LDL-C levels lower, particularly for those at moderately high and high risk for heart disease.
"Nationally, we are far from achieving the 2001 goals, and as new evidence leads the NIH to push optional goals down further, the gap between what we believe to be ideal goals and what has been achieved gets even wider," Persell said.
Too much LDL-C can build up on the inner lining of arteries that feed the brain and heart, and in conjunction with other substances form plaques (deposits) that can clog vessels and cause a stroke or heart attack.
In combination with cardiovascular disease risk factors, such as high blood pressure, diabetes, tobacco smoking and/or family history of heart disease, high levels of LDL-C put individuals at increased risk for heart disease.
The goal for high-risk (heart disease or diabetes) patients is an LDL-C level was less than 100. However, a level of 70, rather than 100, is suggested in updated recommendations for those who are at very high risk for cardiovascular disease.
The new optional goal for those at moderately high risk is 100, compared to the 2001 goal of 130.
The study notes that despite the fact that nearly all persons in the high-risk group have LDL-C levels that are too high, 25 percent of them already use cholesterol-lowering medications, such as statins.
The study shows that many more people would need drug therapy to reach the recommended LDL-C levels, but it notes that a substantial number are unlikely to achieve these goals with standard-dose statins.
Current costs may also place those drugs out of reach for many patients. At current retail prices, a year's supply of 40 milligrams daily of generic lovastatin can cost $450 to $700. Costs per patient would be even higher if name-brand statins or high-dose statins and combination drug therapy are used.
The updated guidelines, published in July 2004, were based on a review of five major clinical studies of statin therapy conducted after the 2001 guidelines were released.
Persell's co-investigators on this study were Donald M. Lloyd-Jones, M.D., assistant professor of preventive medicine and of medicine; and David W. Baker, M.D., associate professor of medicine and chief of general internal medicine at the Feinberg School. 认领了,嘿嘿终于逮着一篇. 胆固醇的理想值与实际值之间距离加大
一项研究估计全美6300万成人低密度脂蛋白的胆固醇（LDL-C）z值高于国立卫生研究所（NIH）推荐的理想值。其中3800万人处于心血管疾病高度危险的状况中。
这项研究由Stephen D. Persell和其西北大学Feinberg医学院的合作者完成，发表在Journal of General Internal Medicine。主要研究者Persell是Feinberg学院的医学助教。
该研究比较了NIH2001年发布的胆固醇参考值和2004年修订的更严格更理想的参考值，并发现，1000多万人的LDL-C（坏胆固醇）值超过了新标准。
新的标准旨在推荐医务人员努力降低病人的LDL-C水平，尤其是对心脏疾病有着中度和高度风险的病人。
Persell说：“就全国而言，我们离2001年的目标已经很远，而且，因为新近的研究使得NIH将LDL-C的理想值降了很多，所以，理想值与实际值的差距就更远了。”
太多的LDL-C能进入心脑动脉血管的内壁，并通过与其他物质连接而形成斑块（沉积下来），从而堵塞血管并能引起突发性心脏病。
如并存有其他心血管疾病危险因子，如：高血压、糖尿病、吸烟和/或心脏病家族史，高水平的LDL-C将极大增加患心脏病的风险。
以前推荐的标准是高危人群（心脏病或糖尿病人）LDL-C值小于100，而新修订的推荐值为小于70。对中度的危险人群，新标准从2001年的130降为100。
该研究表明几乎所有的高危险人群的LDL-C水平都很高，其中有25%的人已经在使用降血脂药物，如statins。
该研究指出，更多的人需要药物治疗才能达到推荐的LDL-C值，而且有一定数量的人用标准剂量的statins无法降至该目标。
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作者:admin@医学,生命科学 2011-03-11 17:12
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