Clinical inertia does not allow healthcare professionals to diagnose cholesterol problems in the 65.3% of cases. The results warn of the need to adopt a more proactive attitude towards a complete dyslipidemia diagnosis in routine clinical practice, especially if it is taken into account that it is an illness related to an increase of cardiovascular risk. The study published in the journal Plos One is part of the ESCARVAL (Estudio Cardiometabólico Valenciano) programme, in which participate researchers at the Universitat Jaume I, Universitat de València and Universidad Miguel Hernández.
The ESCARVAL project not only allows producing an exhaustive epidemiological map of the situation of illnesses such as: diabetes, hypertension and dyslipidemia; but also the chance of producing stratification scales of cardio-metabolic risk for an specific region, the Valencian Community. This study – developed on inertia in dyslipidemia – shows that, in the Valencian Community, 1,395,669 people visited their health center in the second half of 2010. The 48.2% of them had a dyslipidemia diagnosis, while the other 51.8% did not have a dyslipidemia diagnosis in their clinical records, in other words, some of these people could have it undiagnosed. Of these undiagnosed patients – a total of 723,604 – 11,386 were analysed, who had two or more tests to identify lipids over the period of time analysed; only in the 34.7% of cases rates were normal, and that is why the absence of any dyslipidemia diagnosis was justified. In the 65.3% of cases, it was detected that cholesterol problems were undiagnosed, despite existing.
Vicente Pallarés, researcher at the Predepartmental Unit of Medicine at the Universitat Jaume I and member of the Scientific Committee of the ESCARVAL study, highlights that in many cases cholesterol problems do not require pharmacological treatment, but many times changing lifestyles is the initial point in the intervention. However, it is important to diagnose population, as soon as possible, in order to encourage them to change their habits towards a healthier lifestyle and treat them with medication, if necessary. “It is proved that the sooner cholesterol problems are diagnosed, the better it is for avoiding upcoming cardiovascular risks; that is why it is relevant to detect inertia diagnosis and provide the necessary means to avoid it”, he explains.
Vicente Pallarés
The research concludes by warning of the importance of paying special attention to patients with low c-HDL levels, known as “good cholesterol”, because in the 27.3% of cases, it was not diagnosed at the right time, and it is known that it implies an increase of cardiovascular risk. On the other hand, the associated profile in which the inertia diagnosis in dyslipidemia is often seen corresponds to middle-aged woman with hypertension.
ESCARVAL is a project supported by the Valencian Government Health Department, and it has also the collaboration of primary health care scientific societies such as: SEMFYC (Spanish Society of Family and Community Medicine), SEMERGEN (Spanish Society of Primary Health Care Doctors) and the advice of the Loyola University in Chicago (Illinois, USA); with extensive experience in population-based studies, apart from the participation of researchers at the Universitat de València, the Universidad Miguel Hernández and the Universitat Jaume I.
Palazón-Bru A, Gil-Guillén VF, Orozco-Beltrán D, Pallarés-Carratalá V, Valls-Roca F, et al. (2014) Is the Physician’s Behavior in Dyslipidemia Diagnosis in Accordance with Guidelines? Cross-Sectional Escarval Study. PLoS ONE 9(3): e91567. doi:10.1371/journal.pone.0091567 http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0091567