原创力文档a retrospective cohort study of the potency of lipid-lowering therapy and race-gender differences in ldl cholesterol control回顾性队列研究降脂治疗的效能和性别差异的低密度脂蛋白胆固醇控制.pdfVIP
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a retrospective cohort study of the potency of lipid-lowering therapy and race-gender differences in ldl cholesterol control回顾性队列研究降脂治疗的效能和性别差异的低密度脂蛋白胆固醇控制
Turner et al. BMC Cardiovascular Disorders 2011, 11:58
/1471-2261/11/58
RESEARCH ARTICLE Open Access
A Retrospective Cohort Study of the Potency of
lipid-lowering therapy and Race-gender
Differences in LDL cholesterol control
1* 2 1 3
Barbara J Turner , Christopher S Hollenbeak , Mark Weiner and Simon SK Tang
Abstract
Background: Reasons for race and gender differences in controlling elevated low density lipoprotein (LDL) cholesterol
may be related to variations in prescribed lipid-lowering therapy. We examined the effect of lipid-lowering drug
treatment and potency on time until LDL control for black and white women and men with a baseline elevated LDL.
Methods: We studied 3,484 older hypertensive patients with dyslipidemia in 6 primary care practices over a 4-year
timeframe. Potency of lipid-lowering drugs calculated for each treated day and summed to assess total potency for
at least 6 and up to 24 months. Cox models of time to LDL control within two years and logistic regression
models of control within 6 months by race-gender adjust for: demographics, clinical, health care delivery, primary/
specialty care, LDL measurement, and drug potency.
Results: Time to LDL control decreased as lipid-lowering drug potency increased (P 0.001). Black women (N =
1,440) received the highest potency therapy (P 0.001) yet were less likely to achieve LDL control than white men
(N = 717) (fully adjusted hazard ratio [HR] 0.66 [95% CI 0.56-0.78]). Black men (N = 666) and white women (N =
661) also had lower adjusted HRs of LDL control (0.82 [95% CI 0.69, 0.98] and 0.75 [95% CI 0.64-0.88], respectively)
than white men. Logistic regression models of LDL control by 6 months and other sensitivity models affirmed
these resul
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