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Aim:The aim of this study was to assess the prevalence of dyslipidemia and its relation to other cardiovascular risk factors in Lithuania. Design & methods: The Lithuanian High Cardiovascular Risk Primary Prevention program recruited men and women without overt cardiovascular disease. This report describes the group of 23,204 subjects. Results: Dyslipidemia was diagnosed in 89.7% of subjects. All the main cardiovascular risk factors except for smoking were present more often among patients with dyslipidemia. The average number of risk factors (arterial hypertension, abdominal obesity, diabetes mellitus, metabolic syndrome, smoking, insufficient physical activity, unbalanced diet and family history of CVD) in subjects with dyslipidemia was 3.09 (compared with 2.42 in subjects without it). Conclusion: Dyslipidemia is a most frequent risk factor among middle-aged Lithuanian subjects without cardiovascular disease and has been diagnosed in nine out of ten subjects.

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BackgroundAtherogenic dyslipidemia (AD) is a blood serum lipid profile abnormality characterized by elevation of triglycerides and reduced levels of high density lipoprotein cholesterol (HDL-C). It is associated with residual cardiovascular risk. This study evaluated and compared the risk profiles of patients with hypertriglyceridemia, low-HDL-C levels or AD, in order to understand, which lipid profile is associated with greater risk.MethodsDuring the period of 2009–2016 a population of 92,373 Lithuanian adults (men 40–54 years old and women 50–64 years old) without overt cardiovascular disease were analyzed. Data of 25,746 patients (68.6% women and 31.4% men) with hypertriglyceridemia and/or low HDL-C low levels were collected and used for further statistical analysis.ResultsParticipants with AD tend to have more unfavorable risk profile than participants with hypertriglyceridemia or low-HDL-C. AD tends to cluster with other atherogenic risk factors, such as arterial hypertension [odds ratio (OR) 1.96, 95% confidence intervals (CI) 1.87–2.01], smoking [OR 1.20, 95% CI 1.14–1.27], diabetes mellitus [OR 2.74, 95% CI 2.58–2.90], obesity [OR 2.92, 95% CI 2.78–3.10], metabolic syndrome [OR 22.27, 95% CI 20.69–23.97], unbalanced diet [OR 1,59, 95% CI 1.51–1.68], low physical activity [OR 1.80, 95% CI 1.71–1,89], CHD history in first degree relatives [OR 1.18, 95% CI 1.12–1.25] and total number of risk factors [OR 1.47, 95% CI 1.38–1.57].ConclusionAD is associated with more unfavorable cardiovascular risk profile than hypertriglyceridemia or low-HDL cholesterol levels. Once identified AD should require additional medical attention since it is an important factor of residual cardiovascular risk.

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BackgroundCardiovascular mortality in Lithuania is extremely high and abnormal lipid levels are very common among Lithuanian adults. Dyslipidemia is one of the main independent risk factors for cardiovascular diseases (CVD) leading to high absolute CVD risk. The aim of this study was to assess CVD risk in dyslipidemic middle-aged subjects.MethodsDuring the period of 2009–2016 a total of 92,373 people (58.4% women and 41.6% men) were evaluated. This study included men aged 40–54 and women aged 50–64 without overt CVD.ResultsAny type of dyslipidemia was present in 89.7% of all study population. 7.5% of dyslipidemic patients did not have any other conventional risk factors. Three and more risk factors were detected in 60.1% of dyslipidemic subjects. All analyzed risk factors, except smoking, were more common in dyslipidemic adults compared to subjects without dyslipidemia: arterial hypertension (55.8% vs. 43.3%, p < 0.001), diabetes (11.1% vs. 7.3%, p < 0.001), abdominal obesity (45.3% vs. 30.2%, p < 0.001), BMI ≥30 kg/m2 (35.8% vs. 23.7%, p < 0.001), metabolic syndrome (34.0% vs. 9.2%, p < 0.001), family history of coronary heart disease (26.3% vs. 23.1%, p < 0.001), unbalanced diet (62.5% vs. 52.9%, p < 0.001) and insufficient physical activity (52.0% vs. 44.2%, p < 0.001). The prevalence of all evaluated risk factors, except smoking, increased with age. Average SCORE index was 1.87 in all study population, while dyslipidemic subjects had higher SCORE compared to control group (1.95 vs 1.20, p < 0.001).ConclusionsAlmost two thirds of dyslipidemic middle-aged Lithuanian adults without overt cardiovascular disease had three or more other CVD risk factors, which synergistically increase absolute risk of CVD. The average 10-year risk of CVD death in patients with dyslipidemia was 1.95%. The importance of managing dyslipidemia as well as other risk factors in order to reduce burden of cardiovascular disease in Lithuania is evident.

Background Coronary artery calcium (CAC) is known as a reliable tool for estimating risk of myocardial infarction, coronary death, all-cause mortality and is even used to evaluate suitable asymptomatic patients. We therefore aimed to evaluate whether CAC scoring can be applied in the algorithm for clinical examination of patients with severe hypercholesterolemia (SH). Methods During the period of 2016–2017 a total of 213 asymptomatic adults, underwent computed tomography angiography to evaluate their CAC scoring. The sample consisted of 110 patients with SH and 103 age and sex matched controls without dyslipidemia and established cardiovascular disease. Results In total there were 79 (37.2%) subjects with elevated (≥25th) CAC percentiles. Out of them 47 (59.5%) had SH and 32 (40.5%) did not. CAC score did not differ between groups (SH (+) 140.30 ± 185.72 vs SH (−) 87.84 ± 140.65, p = 0.146), however there was a comparable difference in how the participants of these groups distributed among different percentile groups ( p = 0.044). Gender, blood pressure, tabaco use, physical activity, family history of coronary artery disease and diabetes mellitus were not associated with CAC score ( p > 0.05). There were no significant correlations between biochemical parameters and CAC percentiles except for increase in lipoprotein(a) ( p = 0.038). Achilles tendon pathology, visceral obesity, body mass index and increased waist-hip ratio were not associated with CAC percentiles either ( p > 0.05). Conclusions CAC score is not associated with presence of SH. CAC score is not an appropriate diagnostic tool in the algorithm for clinical examination of patients with SH. Further larger studies are needed to support our findings.

BackgroundDyslipidemia is highly prevalent and is one of the major risk factors for cardiovascular disease in Lithuania. The purpose of this study was to determine the prevalence of severe dyslipidemia in Lithuanian middle aged primary prevention population and to investigate cardiovascular risk profile.MethodsThe group of 83,376 people were examined in the Lithuanian High Cardiovascular Risk primary prevention program (LitHiR), during 2009–2015 years. This study recruited middle aged men and women without overt cardiovascular disease. The prevalence of cardiovascular risk factors was compared between severe dyslipidemia group and control group.ResultsSevere dyslipidemia was present in 13.5% (11265) of the subjects; 66.6% (7508) were females. The subjects with severe dyslipidemia had significantly higher rates of arterial hypertension (63.5% vs. 44.2%, p < 0.001), diabetes mellitus (16% vs. 8.1%, p < 0,001), abdominal obesity (51% vs. 30.3%, p < 0.001), body mass index (BMI) > 30 (kg/m2) (38.8% vs. 24.1%, p < 0.001), metabolic syndrome (47.2% vs. 9.2%, p < 0.001), unbalanced diet (66.5% vs. 53.5%, p < 0.001), insufficient physical activity (56% vs. 44.2%, p < 0.001), family history of cardiovascular disease (29.7% vs. 22.7%, p < 0.001) in comparison with control group. Subjects without dyslipidemia had significantly higher rates of smoking (26.4% vs. 22.7%, p < 0.001).The prevalence of familial hypercholesterolemia was 0.1%, very high hypertriglyceridemia - 0.2% and familial mixed dyslipidemia - 0.1% of the subjects examined in the LitHiR programme.ConclusionsHigh prevalence of dyslipidemia remains a major problem in Lithuania. 9 out of 10 people have dyslipidemia, 1 out of 10 - severe dyslipidemia. Severe dyslipidemia is associated with higher frequency of other cardiovascular risk factors.