Zhongguo quanke yixue (Sep 2023)
Risk Stratification of Atherosclerotic Cardiovascular Disease and Lipid Goal Attainment in Hypertensive Patients Registered in Community
Abstract
Background Hypertension and dyslipidemia are major risk factors of cardiovascular and cerebrovascular diseases in Chinese residents. Mastering the risk stratification of atherosclerotic cardiovascular disease (ASCVD) in community residents with hypertension and formulating individualized lipid intervention targets will significantly contribute to the improvement of management of hypertension in primary care and the enhancement of lipid goal attainment rate in residents.Objective To investigate the risk stratification of ASCVD and lipid goal attainment status in hypertensive patients in Beijing's community, providing data support for comprehensive management of hypertension in the community.Methods A total of 2 943 hypertensive patients registered in Yuetan Community Health Center and Qinan Community Health Station from 2019 to 2021 were included. Non-high-density lipoprotein cholesterol (non-HDL-C) was calculated and estimated glomerular filtration rate (eGFR) was calculated from baseline data collected by reviewing health records and electronic medical records. The risk of ASCVD was stratified and blood lipid goal attainment was observed in the patients.Results The participants consisted of 1 201 males and 1 742 females, with a median age of 70 (63, 80) years. High, moderate and low risks of ASCVD were identified in 2 165, 485 and 293 cases, respectively. The LDL-C goal attainment rate was 10.5% (227/2 165) in high-risk patients, 22.9% (111/485) in moderate-risk patients, and 98.0% (287/293) in low-risk patients. Patients with concomitant coronary heart disease had statistically significant higher lipid goal attainment rate than those without 〔14.1% (116/823) vs 9.1% (192/2 120) 〕 (χ2=16.060, P<0.001) . The rate of lipid goal attainment in patients with concomitant stroke was statistically significant higher than that in those without 〔15.5% (41/264) vs 10.0% (267/2 679) 〕 (χ2=7.940, P=0.005) . Conclusion Hypertensive patients with moderate or high risk of ASCVD had low lipid goal attainment rate. And those with high risk of ASCVD and concomitant other high risk factors had unsatisfactory lipid control status. Attention should be paid to the management of blood lipid in hypertension patients to improve their blood lipid control rate and reduce their risk of ASCVD.
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