International Journal of Clinical Pharmacology & Toxicology (IJCPT)    IJCPT-2167-910X-02-202

Dislipidemias in Patients with Cardiopathy Isquemica


Alonso-Rodríguez D1*, Alarcón-Martínez Y2, Moreno-Téllez E3, MCs. Niurka González Costs4

1*Bachelor Of Science pharmaceutical
2First-degree specialist in Clinical Laboratorio.
3Second-degree specialist in Clinical Laboratorio.
4Master in scientific social studies

*Corresponding Author

Dalyla Alonso Rodriguez,
Diagnostic high-technology General Medical Center James Marino,
Aragua, Republic Bolivariana of Venezuela.
E-mail: dalyla@finlay.cmw.sld.cu

Article Type: Review Article
Received: February 20, 2013; Accepted: February 27, 2013; Published: February 28, 2013

Citation: Alonso-Rodríguez D, Alarcón-Martínez Y, Moreno-Téllez E, MCs. Niurka González Costs (2013) Dislipidemias in Patients with Cardiopathy Isquemica. Int J Clin Pharmacol Toxicol. 2(2), 54-57. doi: dx.doi.org/10.19070/2167-910X-1300011

Copyright: Dalyla Alonso Rodríguez© 2013. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.



Abstract

The dislipidemias are a risk factor well recognized of the cardiovascular diseases and constitute a problem of public health. A descriptive study in 150 patient elders of 30 years with diagnosis of Izquemic Cardiopathyes accomplished itself for the sake of identifying dislipidemias in patients of high cardiovascular risk that they helped the high-technology General Medical Center state James Marino Aragua, at the Republic Bolivariana of Venezuela, that you constituted the sign of study from October 2011 to October 2012. They used quantitative and qualitative variables like weight, age, sex, pathological personal background, risk factors cardiovascular associates, seric levels of total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol VLDL cholesterol. 63 percent of patients with dislipidemias were detected, being hypercholesterolemia the more alteration frequently found. The ages un-derstood between 41 and 60 years evidenced the bigger frequency



1.Introduction
2.Methods
    2.1.Procedures and collecting techniques
    2.2.LDL c total cholesterol ( triglycerides/2.2 ) - HDL cholesterol
    2.3.VLDL Triglycerides/2.2
3.Results
4.Discussion
5.Findings
6.Recommendations
7.References

Introduction

The dislipidemias are a group of alterations of lipo -proteínas’s metabolism that are correlated with a car -diovascular high risk.

During last the value of the triglycerides like cardiovas-cular risk factor has put three decades itself in doubt. [ 1, 2] metodological troubles have been one of the reasons that originated the controversy. The ma -jority of the epidemiologic studies that the cardiovas -cular risk to which the concentrations of cholesterol are correlated and triglycerides have measured have done it assuming that lipids are independent variables among themselves and than ailments, in that they raise these parameters, have a similar aterogenic.[3] However, these suppositions do not agree with recent proofs.[4] the type and lipoproteín’s quantity of vari -ous classrooms with different capabilities to deposit in ateroma’s plate reflect The concentration of these lipids.[5]

The mechanisms for which the hiperlipidemias’s big -ger cardiovascular risk is explained are multiple.[6,7] a hiperlipidemia’s existence is synonymous of the accumulate in one or plus types plasma of lipoproteí -nas that they have the capacity to deposit in ateroma’s plates. The majority of the cases have plasmatic con -centrations abnormally highs of remnants of quilomi -crones, of lipoproteins of intermediate or lipoproteins density of low density.[8,9]

The atheroclerotic cardiovascular disease represents the principal cause of the mortality of the occidental world, implicating high costs in the services of health. Although over 200 risk factors for this disease have been identified, epidemiologic recent studies have proven that you level them lifted of cholesterol, partic -ularly the ones belonging to LDL continue cholesterol being the risk factor better established for the develop -ment of the cardiovascular disease.[10,11].

The success of any preventive measure depends on in great part the knowledge of the risk factors and of the impact that its modification can have on the progres -sion of the disease. In the case of the cardiovascular disease, we know a good number of risk factors, and fortunately, many are modifiable, for this reason we intended to Identify the dislipidemias in patients with izqiemic Cardiopathies and to relate with the risk fac -tors cardiovascular associates


Methods

A descriptive research came true, taking like universe the older individuals of 30 years ( 150 patients ) that they helped to the consultation of cardiology of high-technology General Diagnostico’s Medical Center James Mariño located in the status Aragua at the Re -public Bolivariana of Venezuela, in the period from October 2011 to October 2012.

The 150 patients that constituted the universe con -formed the sign of our study.Pregnant women were excluded, patients that suffered intense infarct of the myocardium with less than a month of convalescence, patients with intense infec-tions and those that did not wish to take part in inves -tigation.

The qualitative and quantitative used variables were gathered through the case history of the studied pa -tients and the records of reports of the clinical labora -tory of the center.


Procedures and collecting techniques

The physical measurements came true in the con -sultation of cardiology for the doctor and the nurse. The measurements of laboratory sold off at Clinical Química’s department of the Clinical Laboratory of the General Santiago Marino themselves.

The used variables matched:

Sex

Age ( years )

Seric Concentration of total cholesterol ( mmol L )

Seric concentration of HDL ( mmol L )

Seric concentration of LDL ( mmol L )

Seric concentration of VLDL ( mmol L )

Seric concentration of triglycerides ( mmol L )

The determination of the seric levels of total choles -terol, HDL and triglycerides you accomplished in two occasions each patient, signs they were prosecuted in the automated analyst HITACHI 902, using enzymatic colorimetric methods.

They were guided to the patients to spare them fast of 12 hours and no taking in alcohol 24 previous hours to the sample take. Once the concentration of total cholesterol was deter-mined, HDL and triglycerides. Friedewald’s formula came from to the calculation LDL:


LDL c total cholesterol ( triglycerides/2.2 ) - HDL cholesterol

In the case of the patients with moral values of superior triglycerides to 400 mg/dL ( 4,6 mmol L ), Friede -wald’s formula loses validity and the cholesterol served the purpose of indicator not HDL calculated of the following form:

Cholesterol not total HDL Colesterol - HDL c.

The desirable levels of cholesterol not HDL is of 30

mg/dL more than LDL’s level c.

The VLDL obtained itself by means of the reason:

VLDL Triglycerides/2.2

Referential interval mg/dL ( mmol L ):

Total cholesterol < 200 ( 5,2 )

HDL c  >36 ( 0,9 )

LDL c&npsb < 129 ( 3,4 )

VLDL 30 ( 0,7 )

Triglycerides < 200 ( 2,3 )

Used reproducibility and repetibility like techniques to control exactness and precision, in addition to the multi-calibrator themselves freeze-dried controls Pre-cinorm Or and Precipath Or with standardized con -centrations known in normal and pathological range.Pentium created a data base processed in a microcom -puter for oneself with the information that was ob -tained 4 by means of the statistical program SPSS – 10. The descriptive statistical method of absolute and rela -tive frequency was applicable. The liked Chi’s method was used for the statistical validation.


Results

Source: Primary record of data.


Table 1: Characterization of the patients according to age and sex.
Table 2: Dislipidemias according to the obtained results.
Table 3: Dislipidemias identified according to results.


Source: Primary record of data.



Table 4: Hypercholesterolemia and your relation with age groups and sex.


Source: Primary record of data



Table 5: Hypercholesterolemia and your relation with age groups and sex.


Source: Primary record of data.



Table 6: Mixed Dislipidemia and your relation with age groups and sex.


Source: Primary record of data.



Table 7. Hipoalfalipoproteinemias and your relation with age groups and sex.


Discussion

The success of any preventive measure depends on in great part the knowledge of the risk factors and of the impact that its modification can have on the progres -sion of the disease. In the case of the cardiovascular disease, we know a good number of risk factors, and fortunately, many are modifiable, I eat in the case of the dislipidemias [12].

The population’s bigger percentage manifested itself with dislipidemias, for a 63.3 %, being the most fre-quent alteration hypercholesterolemia. The positive and gradual relation of the concentrations of choles -terol with mortality and morbility for izquemic cardi -opathy, one observes in men and women, young people and old men, in all the races, and so much I eat in patients with clinical symptoms of cardiovascular disease in healthy people [13].

The hypertriglyceridemia, dislipidemia mixed, as well as the hipoalfalipoproteinemia it was more frequent in the patients with ages understood between 51 and 60 years, representing this patients’ group of bigger cardi -ovascular risk, epidemiologic recent studies have prov -en that you level them lifted of cholesterol, particularly the ones belonging to LDL continue cholesterol being he risk factor better established for the development of the cardiovascular disease.

This disease is responsible for 466 over 000 yearly deaths, and those people that outlive some intense cor -onary event, present 15 times more fatal risk than the remaining population, what depends on also other risk factors and clinical complications [14,15].

Groups patients’ poblacionales of the third age mani-fested themselves without alterations in the levels of lipids.

The dislipidemias’s control is, next to the eradication of tobacco addiction and the control of the HTA, dia -betes, obesity and the sedentary life, join of the prin -cipal strategies for the control of the cardiovascular diseases. These strategies attempt avoiding the implan -tation of habits and styles of life that favor the disease ( primary prevention ), to avoid the appearing of new cases of disease between free people of her same ( primary prevention ), and enter the ones that right now have suffered a cardiovascular previous episode (sec -ondary prevention). [16].


Findings

• Hypercholesterolemia is the most frequent dislipidemia.

• The dislipidemias show up with bigger frequency in the masculine sex and in the ages understood between 41 and 60 years.


Recommendations

• Developing an intense communal work for the implementation of a program of comprehensive attention of the dislipidemias.


References

  1. Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Franco A, Olaiz G, Tapia-Conyer R, Sepúlveda J, Rull JA. Características de los casos con dislipidemias mixtas en un estudio de población: resultados de la Encuesta Nacional de Enfermedades Crónicas. Salud Publica Mex 2002;44:546-553.
  2. Kesäniemi YA. Serum triglycerides and clinical benefit in lipid lowering trials. Am J Cardiol 1998;81(4A): 70B-73B.
  3. Sundquist J, Winkleby MA, Pudaric S. Cardiovascular disease risk factors among older black, Mexican-American, and white women and men: An analysis of NHANES 1988-1994. Third National Health and Nutrition Examination Survey. J Am Geriatr Soc 2001;49:109-116.
  4. Gaw A. Evidence based approach for the management of mixed hyperlipidemia. Atherosclerosis 1998;137 Suppl:S97-S100.
  5. Santamarina-Fojo S. The familial chylomicronemia syndrome. Endocrinol Metab Clin North Am 1998; 27:551-567.
  6. Gómez-Pérez FJ, Aguilar-Salinas CA. Hiperlipoproteinemias primarias. En: Posadas C, ed. Dislipidemias y ateroesclerosis. México, D.F.: Editorial Interamericana: McGraw-Hill, 1995: 87-104.
  7. Assmannn G, Schulte H. Results and conclusions of the Prospective Cardiovascular Münster (PROCAM) Study. En: Assmann G, ed. Lipid Metabolism Disorders and Coronary Heart Disease. MMV Medizin Verlag 1993: 21-67.
  8. Frost P, Havel R. Rationale for use of non high density lipoprotein cholesterol rather than low density lipoprotein cholesterol as a tool for lipoprotein cholesterol screening and assessment of risk and therapy. Am J Cardiol 1998;81(4A): 26B-31B.
  9. Sniderman AD, Vu H, Cianflone K. The effect of moderate hypertriglyceridemia on the relation of plasma total and LDL apoB levels. Atherosclerosis 1991; 89:109-116.
  10. Sundquist J, Winkleby MA, Pudaric S. Cardiovascular disease risk factors among older black, Mexican-American, and white women and men: An analysis of NHANES 1988-1994. Third National Health and Nutrition Examination Survey. J Am Geriatr Soc 2001;49:109-116.
  11. Aguilar-Salinas CA, Olaiz G, Valles V, Ríos JM, GómezPérez FJ, Rull JA et al. High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nation wide survey. J Lipid Research 2001; 42:1298-1307.
  12. Cabalé MB, Meneau X, Núñez M, Miguélez R , Ferrer, Rodríguez L. Incidencia de las dislipidemias y su relación con la cardiopatía isquémica en la población del Policlínico ¨Héroes del Moncada¨. Rev Cubana Med Gen Integr v.21 n.5-6 Ciudad de La Habana sep.-dic. 2005.
  13. Toth PP. Low-density lipoprotein reduction in high-risk patients: How low do go? Curr Atheroscler Rep. 2004; 6(5):348-52.
  14. Friday KE. Aggressive lipid management for cardiovascular prevention: evidence from clinical trials. Exp Biol Med. 2003; 228(7) :769-78.
  15. Gotto AM. Triglyceride as a risk factor for coronary artery disease. Am J Cardiol. 1998; 82:22Q-25Q.
  16. Balaguer Vintró I. Estrategias en el control de los factores de riesgo coronario en la prevención primaria y secundaria. Rev Esp Cardiol. 1998; 51 (Supl 6)

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