Prevalence and Clinical Characteristics of Dyslipidemia in Koreans

et al. 2020

Lipids Health Dis

Background: Real-world evidence of low-density lipoprotein cholesterol (LDL-C) goal attainment rates for Asian patients is deficient. The objective of this study was to assess the status of dyslipidemia management, especially in high-risk patients with cardiovascular disease (CVD) including stroke and acute coronary syndrome (ACS). Methods: This was a retrospective cohort study of 514,866 subjects from the National Health Insurance Service-National Health Screening Cohort database in Korea. Participants were followed up from 2002 to 2015. Subjects with a high-risk of CVD prior to LDL-C measurement and subjects who were newly-diagnosed for high-risk of CVD following LDL-C measurement were defined as known high-risk patients (n = 224,837) and newly defined high-risk patients (n = 127,559), respectively. Data were analyzed by disease status: stroke, ACS, coronary heart disease (CHD), peripheral artery disease (PAD), diabetes mellitus (DM) and atherosclerotic artery disease (AAD). Results: Overall, less than 50% of patients in each disease category achieved LDL-C goals (LDL-C < 70 mg/dL in patients with stroke, ACS, CHD and PAD; and LDL-C < 100 mg/dL in patients with DM and AAD). Statin use was observed in relatively low proportions of subjects (21.5% [known high-risk], 34.4% [newly defined high-risk]). LDL-C goal attainment from 2009 to 2015 steadily increased but the goal-achiever proportion of newly defined high-risk patients with ACS remained reasonably constant (38.7% in 2009; 38.1% in 2015). Conclusions: LDL-C goal attainment rates in high-risk patients with CVD and DM in Korea demonstrate unmet medical needs. Proactive management is necessary to bridge the gap between the recommendations of clinical guidelines and actual clinical practice.

Section: Introductionmentioning

confidence: 99%

Low-density lipoprotein cholesterol goal attainment rates in high-risk patients with cardiovascular diseases and diabetes mellitus in Korea: a retrospective cohort study

Yang

et al. 2020

Lipids Health Dis

“…In the United States alone, it is estimated that more than 100 million adults have total cholesterol levels of 200 mg/dL or higher and 31 million adults with total cholesterol levels of 240 mg/dL or higher [1]. Similarly, a previous study estimated that 19.5% of adults in South Korea have dyslipidemia in 2015 [2]. Furthermore, dyslipidemia patients are at increased risk for cardiovascular disease (CVD), the leading cause of death globally.…”

Section: Introductionmentioning

confidence: 99%

Pre-existing Depression among Newly Diagnosed Dyslipidemia Patients and Cardiovascular Disease Risk

Choi

Choi³

et al. 2020

Diabetes Metab J

Background: Whether depression before diagnosis of dyslipidemia is associated with higher cardiovascular disease (CVD) risk among newly diagnosed dyslipidemia patients is yet unclear. Methods: The study population consisted of 72,235 newly diagnosed dyslipidemia patients during 2003 to 2012 from the National Health Insurance Service-Health Screening Cohort of South Korea. Newly diagnosed dyslipidemia patients were then detected for pre-existing depression within 3 years before dyslipidemia diagnosis. Starting from 2 years after the diagnosis date, patients were followed up for CVD until 2015. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated by Cox proportional hazards regression. Results: Compared to dyslipidemia patients without depression, those with depression had higher risk for CVD (aHR, 1.24; 95% CI, 1.09 to 1.41). Similarly, pre-existing depression was associated with increased risk for stroke (aHR, 1.27; 95% CI, 1.06 to 1.53). The risk for CVD among depressed dyslipidemia patients for high (aHR, 1.42; 95% CI, 1.06 to 1.90), medium (aHR, 1.17; 95% CI, 0.91 to 1.52), and low (aHR, 1.25; 95% CI, 1.05 to 1.50) statin compliance patients tended to be increased compared to patients without pre-existing dyslipidemia. The risk-elevating effect of depression on CVD tended to be preserved regardless of subgroups of smoking, alcohol consumption, physical activity, and body mass index. Conclusion: Dyslipidemia patients with pre-existing depression had increased risk for CVD. Future studies that determine CVD risk after management of depression among dyslipidemia patients are needed.

“…The prevalence of dyslipidemia in young adults is relatively high, with estimations ranging from 12.0% to 13.0% 6, 7. Furthermore, several studies have reported that high serum cholesterol in young adults is associated with cardiovascular events in the future 8, 9, 10, 11.…”

mentioning

confidence: 99%

Effect of Change in Total Cholesterol Levels on Cardiovascular Disease Among Young Adults

Jeong

Choi

et al. 2018

JAHA

117

BackgroundAlthough high serum cholesterol in young adults is known to be a predictor for cardiovascular events, there is not enough evidence for the association of cholesterol level change with cardiovascular disease (CVD). This study aimed to evaluate whether the change in cholesterol is associated with incidence of CVD among young adults.Methods and ResultsWe examined 2 682 045 young adults (aged 20–39 years) who had undergone 2 consecutive national health check‐ups provided by Korean National Health Insurance Service between 2002 and 2005. Cholesterol levels were classified into low (<180 mg/dL), middle (180–240 mg/dL) and high (≥240 mg/dL). CVD events were defined as ≥2 days hospitalization attributable to CVD for 10 years follow‐up. Increased cholesterol levels were significantly associated with elevated ischemic heart disease risk (adjusted hazard ration [aHR]=1.21; 95% confidence interval [CI]=1.03–1.42 in low‐high group and aHR=1.21; 95% CI=1.15–1.27 in middle‐high group) and cerebrovascular disease (CEVD) risk (aHR=1.24; 95% CI=1.05–1.47 in low‐high group and aHR=1.09; 95% CI=1.02–1.16 in middle‐high group). Decreased cholesterol levels were associated with reduced ischemic heart disease risk (aHR=0.91; 95% CI=0.88–0.95 in middle‐low group, aHR=0.65; 95% CI=0.56–0.75 in high‐low group and aHR=0.68; 95% CI=0.65–0.73 in high‐middle group). Furthermore, lower cerebrovascular disease risk (aHR=0.76; 95% CI=0.62–0.92) was observed in the high‐low group compared with patients with sustained high cholesterol.ConclusionsThe findings of our study indicate that increased cholesterol levels were associated with high CVD risk in young adults. Furthermore, young adults with decreased cholesterol levels had reduced risk for CVD.