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Time for implementation of hypolipemiant treatment in patient with dyslipidemia in general medicine: results of the Prysme study.

Introduction

Despite of specific guidelines regarding the treatment of dyslipidemia, therapeutic management of patients is not optimal. The objectives of this study were to describe the time for implementation of hypolipemiant treatment and to identify the determinants.

Methods

This was an observational, transversal, prospective, multicenter study carried out in France by general practitioners. Adult patients with dyslipidemia diagnosed since<2 years were eligible for this study. Demographic, diagnosis and disease characteristics, and treatment procedures were collected.

Results

Three thousand six hundred and twenty-four patients were enrolled by 1226 physicians, and data from 3268 patients meeting the selection criteria were analyzed. Mean age was 57 years old, 64% were male. More than 45% of the patients were overweight, 26% were obese. Only 12% of the patients had no cardiovascular risk factor at the time of dyslipidemia diagnosis. The most frequent cardiovascular risk factors consisted in arterial hypertension (50%), smoking (43%), family antecedents of coronary disease (28%), HDL-cholesterol less than 0.4g/L (20%); 15% of the patients had personal antecedents of cardiovascular disease. Initial management of dyslipidemia included implementation of lifestyle changes for 98% of the patients. More than 90% of the patients were treated with a statin. The median time for implementation of hypolipemiant treatment was 2.9 months. The hypolipemiant treatment was initiated more than 3 months after dyslipidemia diagnosis for 43% of the patients. The main determinant factor of an early implementation of hypolipemiant treatment (≤3 months) was secondary prevention (OR=2.2). The number of cardiovascular risk factors had no significant impact.

Conclusion

This study highlights the lack of awareness towards the number of cardiovascular risk factors in the management of dyslipidemia, in primary prevention.

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