High prevalence of dyslipidemia among primary care patients with hypertension and diabetes in Jamaica

Abstract

Introduction: The aim of the study was to determine the prevalence of dyslipidemia among primary care patients with hypertension and diabetes in Jamaica and the proportion of patients who achieve recommended targets. Material and methods : An audit of 500 dockets of adult patients with chronic disease attending public primary care clinics in Jamaica was conducted between October and December 2013. Data were collected on patient characteristics including medical history, medications, anthropometry, and lipid profiles (since January 1, 2011). Lipid targets were based on the Ministry of Health 2007 management guidelines. Stepwise multivariable logistic regression analysis was performed to determine the predictors of achieving lipid targets. Results : Four hundred and thirty-seven patient records had a lipid profile done and 90% of these had at least one abnormal lipid value. 15.3% of the patients achieved the low density lipoprotein cholesterol (LDL-C) target, 63.2% high density lipoprotein cholesterol (HDL-C), 85.1% triglycerides and 57.4% the total cholesterol target. Statins were prescribed for 49% and these patients were less likely to achieve LDL-C (OR = 0.57; 95% CI: 0.33–0.97; p = 0.04) or total cholesterol (OR = 0.21; 95% CI: 0.13–0.33; p < 0.001) targets. Patients over 80 years were more likely to achieve the LDL-C target (OR = 3.21; 95% CI: 1.64–6.28; p = 0.002) than those less than 50 years old. More men than women achieved total cholesterol targets (OR = 2.2; 95% CI: 1.4–3.6; p = 0.001). Conclusions : Dyslipidemia is widespread among primary care patients with hypertension and diabetes. The proportion of patients who achieve the respective lipid targets must be documented and routinely monitored and appropriate medication and lifestyle changes implemented to improve this.