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. 2013 Apr 5;25(4):209–213. [Article in Spanish] doi: 10.1016/S0212-6567(00)78488-5

Riesgo coronario y prescripción en pacientes con hipercolesterolemia en atención primaria

Coronary risk and prescription in primary care patients with hypercholesterolaemia

MV Bonné Moreno 1, O González Löwenberg 1, E Charques Velasco 1, MM Alonso Martínez 1,*
PMCID: PMC7679505  PMID: 10795432

Abstract

Objetivo

Analizar el riesgo coronario, el tratamiento prescrito y determinar si tras un período se modifica el riesgo coronario (RC) de la población con hipercolesterolemia en atención primaria (AP).

Diseño

Observacional transversal.

Emplazamiento

Población consultante en un equipo de AP urbano de Madrid.

Pacientes

Quinientos ochenta y tres pacientes diagnosticados de hipercolesterolemia de ambos sexos y mayores de 25 años que constan en el registro de morbilidad, seleccionados aleatoriamente.

Mediciones y resultados principales

El RC determinado por el método de Framingham lo consideramos alto si es > 20% a los 10 años. Los pacientes con enfermedad cardiovascular (ECV) inicial tienen prescritos hipolipemiantes la mitad de ellos, con más frecuencia los más jóvenes, presentando un colesterol final de 220 mg/dl de media. Entre los pacientes sin ECV inicial, un 32,5% (28,0-36,7%) tiene un RC > 20% y éstos presentan 4,9% (3,0-8,2) más probabilidad de recibir fármacos que los que lo tienen inferior. La prescripción de hipolipemiantes está explicada en un 68% por el RC elevado y la historia familiar de cardiopatía isquémica. Tras al menos un año de seguimiento, constatamos una reducción en la proporción de pacientes con RC alto (diferencia relativa de proporciones 28,7% [20,4-37,1]).

Conclusión

La mitad de los pacientes con ECV o con un RC elevado sin ECV reciben hipolipemiantes. La mayor parte de la prescripción de fármacos está asociada al RC y en la consulta de AP se consigue disminuir la prevalencia de sujetos con RC elevado.

Palabras clave: Atención primaria, Hipercolesterolemia, Prescripción, Riesgo coronario

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