Abstract
Background and objectiveThe Baltic nations (Estonia, Latvia, and Lithuania) are profoundly affected by cardiovascular disease (CVD). Studies have indicated that patients may experience persistent dyslipidemia despite chronic statin treatment. Therefore, the aim of this study was to analyze the risk factors for dyslipidemia despite statin-treatment in a large dataset from the Baltic nations. Material and methodsPatients in primary care centers across the Baltic nations were enrolled into the cross-sectional, observational Dyslipidemia International Study (DYSIS). Patients were ≥45 years old and had been treated with statins for at least three months. Patient characteristics and lipid measurements were used to determine variables contributing to dyslipidemia (abnormal low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], or total triglyceride [TG] values). ResultsWe enrolled 1797 patients with a mean age of 66.1 years and 59.1% being female. Overall 63.4% had cardiovascular disease, 30.1% were diabetic and 77.8% at high risk for cardiovascular complications. LDL-C was not at target level for 80.7%; low HDL-C levels were observed for 26.0%, and elevated TG levels were found in 35.0% of all patients. Multivariate analyses indicated that a BMI≥30kg/m2 (OR, 2.12; 95% CI, 1.45–3.08) and hypertension (OR, 2.43; 95% CI, 1.1 6–5.10) were strongly associated with dyslipidemia (involving all three lipids) during statin therapy while age ≥70 years (OR, 0.63; 95% CI, 0.42–0.94) and female gender (OR, 0.48; 95% CI, 0.33–0.68) conferred reduced risk. ConclusionsOur findings indicate many statin-treated patients in Estonia, Latvia, and Lithuania did not meet target lipid levels and had a very high risk of CVD. Combating other well-known CVD risk factors such as obesity and hypertension is vital to reduce the exceptionally high risk for CVD mortality seen in the Baltic nations.
Highlights
Cardiovascular disease (CVD) is known to be the leading cause of death and disability globally, and the World Health Organization (WHO) has estimated that it accounted for over 30% of the worldwide deaths in 2008
Latvia, and Lithuania are among the most profoundly CVD-affected countries within Europe [4], and 2010 Eurostat statistics indicated that the Baltic nations reported very high mortality rates for stroke compared to other countries in the European Union (EU), and comprised three out of the four countries with the highest rates of coronary heart disease-related mortality in Europe (OECD, 2012)
Dyslipidemia International Study (DYSIS) in the Baltics was an observational, cross-sectional, multicenter study conducted in Estonia, Latvia, and Lithuania between September 2011 and November 2012
Summary
Cardiovascular disease (CVD) is known to be the leading cause of death and disability globally, and the World Health Organization (WHO) has estimated that it accounted for over 30% of the worldwide deaths in 2008. Latvia, and Lithuania (collectively known as the Baltics) are among the most profoundly CVD-affected countries within Europe [4], and 2010 Eurostat statistics indicated that the Baltic nations reported very high mortality rates for stroke compared to other countries in the EU, and comprised three out of the four countries (in addition to the Slovak Republic) with the highest rates of coronary heart disease-related mortality in Europe (OECD, 2012). In the Baltic region, there is currently a vital need to implement preventative measures for combating well-known CVD risk factors, including hypertension, diabetes, smoking, and high cholesterol. The Baltic nations (Estonia, Latvia, and Lithuania) are profoundly affected by cardiovascular disease (CVD). The aim of this study was to analyze the risk factors for dyslipidemia despite statin-treatment in a large dataset from the Baltic nations. LDL-C was not at target level for 80.7%; low HDL-C levels were
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