Estudio observacional en el área 10: manejo de la hipercolesterolemia en ancianos diabéticos1

Villares Rodríguez, J.E.; Ruiz García, A.; Herreros Tabernero, B.; Hermosa Hernán, J.C.; Gordillo López, F.J.; López Gallardo, M.P.; Del Pozo Sosa, G.

doi:10.1016/S0211-139X(01)74722-1

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Objetivo

Describir el nivel de cumplimiento de los criterios del adecuado manejo de la hipercolesterolemia en la población anciana con dislipemia y diabetes, realizado por los médicos de Atención Primaria.

Población Y Métodos

Estudio observacional transversal con 38 médicos de Atención Primaria (Área 10 INSALUD Madrid), y 272 pacientes ≥ 65 años con hipercolesterolemia y diabetes. Se evaluó el nivel de cumplimiento de las recomendaciones del National Cholesterol Education Program (NCEP).

Resultados

El 94,12% [90,44; 96,49 (IC 95%)] de los sujetos de estudio tenían dos o más factores de riesgo cardiovasculares, y el 27,21% [22,09; 32,98 (IC 95%)], padecían cardiopatía isquémica u otra enfermedad vascular arteriosclerótica. El tratamiento de la hipercolesterolemia con dieta exclusivamente, se realizó en el 66,54% [60,55; 72,06 (IC 95%)] de los pacientes. El tratamiento farmacológico con estatinas se realizó en el 19,49% [15,05; 24,80 (IC 95%)] de las ocasiones, con fibratos en el 11,76% [8,30; 16,34 (IC 95%)], y con resinas en el 2,21% [0,90; 4,97 (IC 95%)]. El nivel de cumplimiento de los criterios de adecuado manejo de la hipercolesterolemia en sujetos de estudio fue del 41,91% [36,02; 48,03 (IC 95%)].

Conclusión

La hipercolesterolemia en la población anciana con diabetes no es tratada adecuadamente en el 58,09% [51,97; 63,98 (IC 95%)] de las ocasiones. Se hace necesario investigar las razones que influyen en el inadecuado manejo de la dislipemia en esta población.

Palabras clave:

Médicos de Atención Primaria

Agentes hipolipemiantes

Ancianos

Diabetes

Dislipemia

Background

The study aims to describe the criteria fulfillment rate of adequate hypercholesterolemia treatment in the elderly population with dyslipemia and diabetes achieved by primary care physicians.

Population And Methods

Cross-sectional study with 272 patients aged = 65 years with hypercholesterolemia and diabetes, and with 38 primary care physicians. Setting: Area 10 Primary Care (National Institute of Health of Spain). The fulfillment level of the recommendations of the National Cholesterol Education Program (NCEP) was evaluated.

Results

94.12 percent [90.44; 96,49 (CI 95%)] of study patients had two or more mayor atherosclerotic risk factors and 27.21 percent [22.09; 32.98 (CI 95%)] had coronary heart or atherosclerotic vascular diseases. Hypercholesterolemia was treated only by diet in 66.54 % [60.55; 72.06 (CI 95%)] of the patients. HMG-CoA-reductase inhibitors were used in the 19.49 % [15.05; 24.80 (CI 95%)], fibrate acid derivatives were used in the 11.76 percent [8.30; 16.34 (CI 95%)], and the resins were prescribed in the 2.21 percent [0.90; 4.97 (CI 95%)] of the patients. The rate of adequate hypercholesterolemia management in the study patients was 41.91 percent [(36.02; 48.03 (CI 95%)].

Conclusions

Hypercholesterolemia in the elderly population with diabetes is not adequately managed by primary care physicians in 58.09% percent [51.97; 63.98 (CI 95%)]. More studies are necessary to assess the reasons that influence inadequate management of hypercholesterolemia in this population.

Key words:

Hypercholesterolemia

Primary care physicians

Diabetes

Elderly population

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