Hyperlipidemias: Bongard V

Bongard V, Ferrières J. · Service d'épidémiologie, CHU de Toulouse, faculté de médecine. · Rev Prat. · Pubmed #16548253 No free full text.

This publication has no abstract.

Bongard V, Cambou JP, Lezorovcz A, Ferrères J, Vahanan A, Jullen G, Coppe G, Guerllot M, Herrmann MA, Mas JL. · Department of Epidemiology, Toulouse University School of Medicine and INSERM U558, Toulouse, France. · Eur J Cardiovasc Prev Rehabil. · Pubmed #15616412 No free full text.

Abstract: BACKGROUND: Atherothrombosis is a systemic disease affecting coronary, cerebral, and lower limb arteries, and requiring secondary prevention measures. DESIGN: Data from three observational studies carried out in 1999-2000 (ECLAT1, APRES, PRISMA) were pooled to describe the prevalence of cardiovascular risk factors and the patterns of drug use in atherothrombotic patients. METHODS: General practitioners and cardiologists engaged in a private practice and evenly distributed in France recruited consecutive patients who had a history of at least one atherothrombotic event: myocardial infarction (MI), ischaemic stroke, and/or peripheral arterial disease (PAD). RESULTS: The sample was composed of 14 544 patients (men: 75.0%, age 75 or older: 31.0%). At least one of the four major risk factors (smoking, hypertension, hypercholesterolaemia, diabetes) was present in 94.3% of the sample. Prevalence of drug use was: 78.8% (antiplatelet agents), 48.5% (statins), 36.7% (beta-blockers), and 33.4% [angiotensin-converting enzyme (ACE) inhibitors]. After adjustment for confounders, statins were taken in a significantly larger extent in patients with a history of isolated MI than in those with a previous ischaemic stroke or PAD, or in patients who suffered from both MI and ischaemic stroke. Isolated MI (as compared with ischaemic stroke and PAD) was significantly and independently associated with a higher probability to take antiplatelet agents, beta-blockers or ACE inhibitors. CONCLUSIONS: At least one conventional risk factor was observed in almost all atherothrombotic patients. Use of preventive drugs was lower in patients with a history of ischaemic stroke or PAD, and should increase, accordingly to the results of recent randomized controlled trials.

Bongard V, Ruidavets JB, Dallongeville J, Simon C, Amouyel P, Arveiler D, Ducimetière P, Ferrières J. · Department of Epidemiology, INSERM U558, Faculté de Médecine, Toulouse, France. · Eur J Clin Nutr. · Pubmed #15116082 No free full text.

Abstract: OBJECTIVE: To compare the dietary intakes of free-living people with and without previously diagnosed diet-modifiable cardiovascular risk factors (hypertension, hypercholesterolaemia and diabetes). DESIGN: Cross-sectional survey on cardiovascular risk factors including a three-consecutive-day food record. SETTING: Multicentre setting in Lille (northern France), Strasbourg (north-east) and Toulouse (south-west) areas. SUBJECTS: A total of 1072 middle-aged men randomly selected from the general population: group 1 (504 men without previously diagnosed diet-modifiable risk factor), group 2 (377 men with one previously diagnosed diet-modifiable risk factor) and group 3 (191 men with two or three previously diagnosed diet-modifiable risk factors). INTERVENTIONS: None. RESULTS: Total daily energy intake equalled 10731 kJ/day (standard error: 119), 9991 (138) and 9737 (166) in groups 1, 2 and 3, respectively (P<0.0001 for ANOVA comparing the three groups), and daily energy intake without alcohol equalled 9860 (115), 9096 (132) and 8654 (159) kJ/day (P<0.0001). The proportion of calories from animal proteins (in daily energy intake without alcohol) increased from group 1 to 3 (P<0.0001), whereas the proportion from oligosaccharides decreased (P<0.0001). The proportion of calories from alcohol (in total daily energy intake) increased with the number of risk factors (P<0.0001). These results remained significant after adjustment for confounders. No significant group differences were found in the proportions of energy from polysaccharides, saturated, monounsaturated and polyunsaturated fats. CONCLUSIONS: As compared with subjects without risk factor, significant quantitative and qualitative changes are observed in individuals with diagnosed hypertension, hypercholesterolaemia or diabetes. However, lower consumptions of saturated fats and alcohol are needed.

Marques-Vidal P, Bongard V, Ruidavets JB, Fauvel J, Perret B, Ferrières J. · INSERM U558, Faculté de Médecine Purpan, Toulouse, France. · Am J Cardiol. · Pubmed #14583365 No free full text.

Abstract: The effects of the apolipoprotein E epsilon and angiotensin-converting enzyme insertion/deletion alleles on lipid levels and hypolipidemic drug treatment was assessed in 400 men with stable angina pectoris or healed myocardial infarction and 338 healthy controls. The data indicate that epsilon4 carriers have increased total and low-density lipoprotein cholesterol levels, that the epsilon4 allele unfavorably decreases the efficiency of statin treatment, and that the angiotensin-converting enzyme insertion/deletion polymorphism exerts no significant effect, with the exception of an increase in apolipoprotein E levels.

Marques-Vidal P, Bongard V, Arveiler D, Amouyel P, Ducimetière P, Ferrières J. · INSERM U558, Faculté de médecine, département d'épidémiologie, 37, allées Jules Guesde, 31073 Toulouse. · Arch Mal Coeur Vaiss. · Pubmed #12055766 No free full text.

Abstract: AIM: To assess the cost of the preventive measures against hypertension and dyslipidemia in French subjects aged 35-64 years. METHODS: Cross-sectional study conducted in 433 men and 424 women from the three French centres participating in the WHO-MONICA Project and receiving antihypertensive and/or hypolipidemic drug therapy. RESULTS: In both genders, beta-blockers and ACE inhibitors were the most frequently prescribed antihypertensive drugs, and half of treated hypertensive subjects still had blood pressure levels beyond the normal limits, this percentage being lower in men and in Bas-Rhin. Daily cost of antihypertensive treatment ranged between 0.58 (minimum) and 1.72 [symbol: see text] (maximum) in men and between 0.54 and 1.46 [symbol: see text] in women, with no differences between centers. Fibrates were the most frequently prescribed hypolipidemic drug, and daily cost of treatment ranged between 0.33 and 1.33 [symbol: see text] in men and between 0.36 and 1.26 [symbol: see text] in women; in men, costs were lower in the Communauté Urbaine de Lille. Slightly more than half of the hyperlipidemic subjects had their LDL levels within normal values; no differences were found between centers or genders. Finally, the daily cost of "therapeutic inefficiency" for hypertension and dyslipidemia for age group 35-64 years in France was estimated to be over one million [symbol: see text]. CONCLUSION: The cost of the antihypertensive and hypolipidemic drug treatment is high and efforts should be undertaken in order to increase the efficiency of prevention.