medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2005, Número 1

<< Anterior Siguiente >>

Rev Invest Clin 2005; 57 (1)


Aplicabilidad del III Programa Nacional de Educación en Colesterol (NCEP-III). Guías para el tratamiento de la dislipidemia en una población no caucásica. Un estudio en toda la nación mexicana

Rojas R, Aguilar-Salinas CA, Gómez-Pérez FJ, Valles V, Franco A, Olaiz G, Sepúlveda J, Rull JA

Idioma: Ingles.
Referencias bibliográficas: 34
Paginas: 28-37
Archivo PDF: 75.23 Kb.


RESUMEN

Evaluamos el impacto de las recomendaciones del Programa Nacional de Educación en Colesterol (NCEP-III) en muestra poblacional. La información proviene de 2,201 sujetos de 20 a 69 años cuyas muestras se obtuvieron después de un ayuno de 9 a 12 horas. Una condición con riesgo cardiovascular equivalente al de la cardiopatía isquémica se encontró en 10.5%; ≥ 2 factores de riesgo se encontraron en 41.7%. El colesterol LDL (LDL-C) fue suficientemente alto (› 160 mg/dL) para indicarse tratamiento hipolipemiante con medicamentos, en ausencia de otros factores de riesgo en 10% de los participantes. El 25% de la población calificó para recibir tratamiento hipolipemiante (cambios del estilo de vida 15.9% y tratamiento farmacológico en 11.7%). En casos con ≥ 2 factores de riesgo, un pequeño porcentaje (1.8%) fue identificado con riesgo mayor a › 20% de tener un evento cardiovascular a 10 años; 86.3% fue identificado con bajo riesgo (‹ 10% a 10 años). La mayoría de los casos con síndrome metabólico (84%) fueron identificados en el grupo de bajo riesgo. Como resultado, sólo 17.6% de ellos calificó para disminuir su LDL-C con medicamentos. Nuestros datos demuestran el reto que representa la prevención de complicaciones cardiovasculares por medio de la reducción de la concentración del LDL-C. Extrapolando nuestros datos al censo 2000, más de 5.8 millones de mexicanos califican para recibir tratamiento farmacológico de acuer-do con los criterios del NCEP-III.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Frohlich J, Fodor G, McPherson R, Genest J, Langer N for the Dyslipidemia Working Group of Health Canada. Can J Cardiol 1998; 14(Suppl. A): 17A-21A.

  2. British Cardiac Society, British Hyperlipidemia Association, British Hypertension Society, British Diabetic Association. Joint British recommendations on prevention of coronary heart disease in clinical practice: summary. BMJ 2000; 320: 705-8.

  3. American College of Physicians. Guidelines for using serum cholesterol, high density lipoprotein cholesterol and triglycerides levels as screening tests for preventing coronary heart disease in adults. Part 1. Ann Intern Med 1996; 124: 515-17.

  4. Expert panel on detection, evaluation and treatment of high blood cholesterol in adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation and treatment of high cholesterol. JAMA 2001; 285: 2486-97.

  5. Grundy SM, Pasternak R, Greenland P, Smith S, Fuster V. Assessment of cardiovascular risk by use of multiple risk factor assessment equations. Circulation 1999; 100; 1481-92.

  6. Fedder D, Koro C, L’Italien G. New National Cholesterol Education Program III guidelines for primary prevention lipid-lowering drug therapy. Circulation 2002; 105: 152-6.

  7. Rodriguez C, Pablos-Méndez A, Palmas W, Lantigua R, Mayeux R, Berglund L. Comparison of modifiable determinants of lipids and lipoprotein levels among African-Americans, Hispanics and non-Hispanic Caucasians ³ 65 years of age living in New York City. Am J Cardiol 2002; 89: 178-83.

  8. Mitchell BD, Gonzalez Villalpando C, Arredondo Perez B, Garcia MS, Valdez R, Stern MP. Myocardial infarction and cardiovascular risk factors in Mexico City and San Antonio, Texas. Arterioscler Thromb Vasc Biol 1995; 15: 721-5.

  9. Bhopal R, Unwin N, White M, Yallop J, Walker L, Alberti KGMM, Harland J, Patel S, Ahmad N, Turner C, Watson B, Kaur D, Kulkarni A, Laker M, Tavridou A. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladesh, and European origin populations: cross sectional study. BMJ 1999; 319: 215-20.

  10. Aguilar-Salinas CA, Olaiz G, Valles V, Ríos JM, Gómez Pérez FJ, Rull JA, Rojas R, Franco A, Sepúlveda J. High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nation wide survey. J Lipid Research 2001; 42: 1298-307.

  11. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, García E, Valles V, Ríos-Torres JM, Franco A, Olaiz G, Sepúlveda J, Rull JA. Early onset type 2 diabetes in a Mexican, population-based, nation-wide survey: Am J Med 2002; 113: 569-74.

  12. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, Olaiz G, Rull JA, Sepulveda J. High prevalence of the metabolic syndrome in Mexico. Arch Med Res 2004; 35: 76-81.

  13. Valles V, Aguilar-Salinas CA, Gómez-Pérez FJ, Rojas R, Franco A, Olaiz G, Rull JA, Sepúlveda J. Apolipoprotein B and AI distribution in the Mexican urban adults: Results of a Nation-Wide Survey. Metabolism 2002; 51: 560-8.

  14. Aguilar Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, Olaiz G, Rull JA , Sepulveda J. Analysis of the agreement between the World Health Organization criteria and the National Cholesterol Education Program Definition of the metabolic syndrome (short report). Diabetes Care 2003; 26: 1635.

  15. Instituto Nacional de Geografía y Estadística. Censo Nacional de Población 1990.

  16. Aguilar-Salinas CA, Delgado A, Gómez-Pérez FJ. The advantages of using non-HDL cholesterol in the diagnosis and treatment of dislipidemias (letter). Arch Intern Med 2002; 162: 102-6.

  17. Frost P, Havel R. Rationale for use of non high density lipoprotein cholesterol rather than low density lipoprotein cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy. Am J Cardiol 1998; 81: 26B-31B.

  18. Friedewald WT, Levy IR, Fredrickson DS. Estimation of the concentration of low density lipoproteins cholesterol in plasma without the use of the ultracentrifuge. Clin Chem 1972; 18: 449–502.

  19. 2000 Mexican population census. Available at: www.inegi.gob.mx. Accessed April 12, 2002.

  20. Gotto A, Kuller L. Eligibility for lipid-lowering drug therapy in primary prevention: How do the Adult Treatment Panel II and the Adult Treatment Panel III guidelines compare? Circulation 2002; 105: 136-9.

  21. 2000 US population census. Available at: www.censusscope.org. Accessed September 20, 2004.

  22. World Health Organization. Surveillance of risk factors related to noncommunicable diseases: current status of global data (SURF report). Available at: www.who.int/ncd/surveillance/surveillance_publications.htm. Accessed September 20, 2004.

  23. Cappuccio F, Oakeshott P, Strazzullo P, Kerry S. Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study. BMJ 2002; 1271-7.

  24. Grundy SM, D’Agostino R, Mosca L, Burke G, Wilson P, Rader D, Cleeman J, Roccella E, Cutler J, Friedman L. Cardiovascular risk assessment based on US cohort studies: findings from a National Heart, Lung and Blood Institute Workshop. Circulation 2001; 104: 491-6.

  25. Liu J, Hong Y, D’Agostino R, Wu Z, Wang W, Sun J, Wilson P, Kannel W, Zhao D. Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with Chinese multi-provincial cohort study. JAMA 2004; 291: 2591-9.

  26. D’Agostino R, Grundy SM, Sullivan L, Wilson P for the CHD risk prediction group. Validation of the Framingham coronary heart disease prediction scores: Results of a multiple ethnic groups investigation. JAMA 2001; 286: 180-7.

  27. Klein B, Klein R, Lee K. Components of the metabolic syndrome and risk of cardiovascular disease and diabetes in Beaver Dam. Diabetes Care 2002; 25: 1790-4.

  28. Malik S, Wong N, Franklin S, Kamath T, L’Italien G, Pio J, Williams R. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease and all causes in United States adults. Circulation 2004; 110: 1245-50.

  29. Girman C, Rhodes T, Mercuri M et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Am J Cardiol 2004; 93: 136-41.

  30. Despres JP, Lemieux I, Dagenais GR et al. Evaluation and management of atherogenic dyslipidemia: beyond low-density lipoprotein cholesterol. CMAJ 2001; 13: 1331-3.

  31. Jacobson TA, Case CC, Roberts S, Buckley A, Murtaugh KM, Sung JC, Gause D, Varas C, Ballantyne CM. Characteristics of US adults with the metabolic syndrome and therapeutic complications. Diabetes Obes Metab 2004; 6: 353-62.

  32. Sánchez-Castillo CP, Velázquez-Monroy O, Berber A, Lara-Esqueda A. Tapia-Conyer R, James PT and the Encuesta Nacional de Salud (ENSA) 2000 Working Group. Anthropometric cutoff points for predicting chronic diseases in the Mexican National Health Survey 2000. Obesity Res 2003; 11: 442-51.

  33. Aguilar-Salinas CA, Vazquez-Chavez C, Gamboa-Marrufo R, García Soto N, Ríos Gonzalez JJ, Holguín R, Vela S, Ruiz Alvarez F, Mayagoitia S. Prevalence of obesity, diabetes, hypertension and tobacco consumption in an urban adult Mexican population. Arch Med Res 2001; 32: 446-53.

  34. Ford E, Giles W, Dietz W. Prevalence of the metabolic syndrome among US adults. JAMA 2002; 287: 356-9.




2020     |     www.medigraphic.com