Tags

Type your tag names separated by a space and hit enter

Managing dyslipidemia in Turkey: suggested guidelines for a population characterized by low levels of high density lipoprotein cholesterol.
Anadolu Kardiyol Derg 2002; 2(4):315-22AK

Abstract

Based on data from the Turkish Society of Cardiology and others, it is established that Turks have a high prevalence of coronary heart disease (CHD). Several risk factors are prominent in Turks: dyslipidemia, cigarette smoking, and hypertension. The dyslipidemia is unique in that very low levels of HDL-C and typically "normal" LDL-C levels characterize the Turkish population. The low HDL-C levels appear to be genetic in origin and are largely independent of high triglyceride levels (73% of Turkish men and 94% of women with HDL-C <40 mg/dl have triglyceride levels <150 mg/dl; only 15% of men and 3% of women with HDL-C <40 mg/dl have triglyceride levels >200 mg/dl). HDL-C levels are 10-15% mg/dl lower in Turks than seen in the United States or western Europe. Low HDL-C is a major risk factor; CHD risk increases 2-4% for every 1 mg/dl decrease in HDL-C levels. Existing treatment guidelines focus on plasma LDL-C levels and fail to take into account the continuous increase in CHD risk that occurs as HDL-C levels decrease. However, several studies show that patients with CHD or free of CHD but with multiple risk factors, who have low HDL-C and near optimal LDL-C, benefit very significantly from lipid-lowering therapy. Many of these patients with low HDL-C levels do not qualify for drug therapy based on existing guidelines. Therefore, we believe that unique guidelines must be developed to guide the treatment of low HDL-C Turkish patients. We suggest that treatment based on both the LDL-C level and the total cholesterol/HDL-C (TC/HDL-C) ratio is the best way to address treatment of patients with low HDL-C levels. The most effective drug treatment available presently in Turkey relies on lowering LDL-C levels to optimize the TC/HDL-C ratio.

Authors+Show Affiliations

Gladstone Institute, Koç American Hospital, Istanbul, Turkey, and Gladstone Institute of Cardiovascular Disease, University of California, San Francisco, California, USA. tbersot@gladstone.ucsf.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

12460830

Citation

Bersot, Thomas P., et al. "Managing Dyslipidemia in Turkey: Suggested Guidelines for a Population Characterized By Low Levels of High Density Lipoprotein Cholesterol." Anadolu Kardiyoloji Dergisi : AKD = the Anatolian Journal of Cardiology, vol. 2, no. 4, 2002, pp. 315-22.
Bersot TP, Palaoğlu KE, Mahley RW. Managing dyslipidemia in Turkey: suggested guidelines for a population characterized by low levels of high density lipoprotein cholesterol. Anadolu Kardiyol Derg. 2002;2(4):315-22.
Bersot, T. P., Palaoğlu, K. E., & Mahley, R. W. (2002). Managing dyslipidemia in Turkey: suggested guidelines for a population characterized by low levels of high density lipoprotein cholesterol. Anadolu Kardiyoloji Dergisi : AKD = the Anatolian Journal of Cardiology, 2(4), pp. 315-22.
Bersot TP, Palaoğlu KE, Mahley RW. Managing Dyslipidemia in Turkey: Suggested Guidelines for a Population Characterized By Low Levels of High Density Lipoprotein Cholesterol. Anadolu Kardiyol Derg. 2002;2(4):315-22. PubMed PMID: 12460830.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managing dyslipidemia in Turkey: suggested guidelines for a population characterized by low levels of high density lipoprotein cholesterol. AU - Bersot,Thomas P, AU - Palaoğlu,K Erhan, AU - Mahley,Robert W, PY - 2002/12/4/pubmed PY - 2003/3/11/medline PY - 2002/12/4/entrez SP - 315 EP - 22 JF - Anadolu kardiyoloji dergisi : AKD = the Anatolian journal of cardiology JO - Anadolu Kardiyol Derg VL - 2 IS - 4 N2 - Based on data from the Turkish Society of Cardiology and others, it is established that Turks have a high prevalence of coronary heart disease (CHD). Several risk factors are prominent in Turks: dyslipidemia, cigarette smoking, and hypertension. The dyslipidemia is unique in that very low levels of HDL-C and typically "normal" LDL-C levels characterize the Turkish population. The low HDL-C levels appear to be genetic in origin and are largely independent of high triglyceride levels (73% of Turkish men and 94% of women with HDL-C <40 mg/dl have triglyceride levels <150 mg/dl; only 15% of men and 3% of women with HDL-C <40 mg/dl have triglyceride levels >200 mg/dl). HDL-C levels are 10-15% mg/dl lower in Turks than seen in the United States or western Europe. Low HDL-C is a major risk factor; CHD risk increases 2-4% for every 1 mg/dl decrease in HDL-C levels. Existing treatment guidelines focus on plasma LDL-C levels and fail to take into account the continuous increase in CHD risk that occurs as HDL-C levels decrease. However, several studies show that patients with CHD or free of CHD but with multiple risk factors, who have low HDL-C and near optimal LDL-C, benefit very significantly from lipid-lowering therapy. Many of these patients with low HDL-C levels do not qualify for drug therapy based on existing guidelines. Therefore, we believe that unique guidelines must be developed to guide the treatment of low HDL-C Turkish patients. We suggest that treatment based on both the LDL-C level and the total cholesterol/HDL-C (TC/HDL-C) ratio is the best way to address treatment of patients with low HDL-C levels. The most effective drug treatment available presently in Turkey relies on lowering LDL-C levels to optimize the TC/HDL-C ratio. SN - 1302-8723 UR - https://www.unboundmedicine.com/medline/citation/12460830/Managing_dyslipidemia_in_Turkey:_suggested_guidelines_for_a_population_characterized_by_low_levels_of_high_density_lipoprotein_cholesterol_ L2 - http://www.anatoljcardiol.com/linkout/?PMID=12460830 DB - PRIME DP - Unbound Medicine ER -