Linking of different ethnicities, races and religions to lipid profile patterns and hypolipidaemic drug usage patterns in coronary artery disease patients
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20193167Keywords:
Caste, Coronary artery disease, Ethnicity, Hypolipidaemic drugs, Lipid profile patterns, ReligionAbstract
Background: Coronary artery disease (CAD) is the consequence of atherosclerosis in which inadequate blood flow in the coronary arteries leads to myocardial necrosis. The impact of ethnic on CAD might be underestimated within Indian communities. There have never been any studies done associating them to lipid profile patterns in the Indian setup hence this study is the first of its kind to work towards attending the absence of data in this direction.
The study aimed to evaluate the presence of ethnic differences in lipid profile patterns and hypolipidemic drug use in CAD patients.
Methods: An 8-week cross-sectional prospective study was conducted in the cardiology OPD of a tertiary care hospital. Adult CAD patients prescribed with at least one hypolipidaemic drug, having their lipid profile values and willing to give informed consent were selected. The prescription pattern was noted, and the lipid profile values of the patients classified as per ATP III guidelines by NCEP. Atherogenic dyslipidaemia was considered when patients had triglyceride levels >150 mg/dl and HDL<40 mg/dl. The collected data was analyzed using SPSS. P value less than 0.05 was considered as statistically significant.
Results: A total of 123 patients enrolled. Out of these, 115 were Hindus and among Hindus, most were Brahmins (34). The most prescribed hypolipidaemic drug was Rosuvastatin. Thirty six patients had high triglyceride levels out of which 35 were Hindus. Low HDL (<40 mg/dl) was present in 70 patients out of which 64 were Hindus. Atherogenic dyslipidaemia was seen in 44 patients. Majority of them belonged to the age group of 51-60 years (43.2%) and were Patels. Total cholesterol and LDL were high in 1 and 2 Jains respectively. Lipid values were higher in Tier-3 city patients.
Conclusion: Hindu patients in this study showed a poorer lipid profile while among the castes, Jains and Patel’s fared poorly. It was seen that atherogenic dyslipidemia is on a rise in the Indian population.
References
Mendis S, Puska P, Norrving B. Global atlas on cardiovascular disease prevention and control/edited by: Shanthi, Mendis et.al. Geneva: World Health Organization. 2011. Available at http://www.who.int/iris/handle/10665/44701. accessed 06 June 2019.
Carleton RA, Dwyer J, Finberg L, Flora J, Goodman DS, Grundy SM, et al. Report of the Expert Panel on Population Strategies for Blood Cholesterol Reduction. A statement from the National Cholesterol Education Program, National Heart, Lung, and Blood Institute, National Institutes of Health. Circulation. 1991 Jun;83(6):2154-232.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972 Jun;18(6):499-502.
Patel J, Sheehan V, Gurk-Turner C: a new type of lipid lowering agent. Proc. 2003;16(3):354-8.
Iyengar S, Puri R, Narasingan S. Lipid Association of India Expert Consensus Statement on Management of Dyslipidemia in Indians 2016: Part 1-Executive summary. J Clin Prev Cardiol. 2016;2(2);134.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002 Dec17;106(25):3143-421.
Mathur, R; (2015) Ethnic inequalities in health and use of healthcare in the UK: how computerized health records can contribute substantively to the knowledge base. PhD thesis, London School of Hygiene & Tropical Medicine. Available at: http://researchonline.lshtm.ac.uk/2478832/.
Lip GY, Barnett AH, Bradbury A, Cappuccio FP, Gill PS, Hughes E, et.al. Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management. J Hum Hypertens. 2007 Mar;21(3):183-211.
Frank AT, Zhao B, Jose PO, Azar KM, Fortmann SP, Palaniappan LP. Racial/ethnic differences in dyslipidemia patterns. Circulation. 2014 Feb 4;129(5):570-9.
Grundy SM. Atherogenic dyslipidemia: Lipoprotein abnormalities and implications for therapy. Am J Cardiol. 1995;75:45B-52B.
Manjunath CN, Rawal JR, Irani PM, Madhu K. Atherogenic dyslipidaemia. Indian J Endocrinol Metab. 2013 Nov-Dec;17(6):969-76.
Mahalle N, Garg MK, Naik SS, Kulkarni MV. Study of pattern of dyslipidemia and its correlation with cardiovascular risk factors in patients with proven CAD. Indian J Endocrinol Metab. 2014 Jan;18(1):48-55.
Sangeetha Raja. Prescription pattern of hypolipidemic drugs, PCOS patients. J Clin Diagn Res. 2014 Apr;8(4):HC01-3.
Gupta S, Kumar R, Kumar D, Bhat S, Kumar D, Bhat NK et al. Study of prescribing patterns of hypolipidemic agents in a tertiary care teaching hospital in North India. Natl J Physiol Pharm Pharmacol. 2017;7(2):198-202.
Patel KP, Joshi HM, Khandhedia C, Shah H, Shah KN, Patel VJ. Study of drug utilization, morbidity pattern and cost of hypolipidemic agents in a tertiary care hospital. Int J Basic Clin Pharmacol. 2013;2:470-5.
C.Lahoz, J.M.Mostaza, S.Tranche. Atherogenic dyslipidemia in patients with established coronary artery disease. Nutr Metab Cardiovasc Dis. 2012 Feb;22(2):103-8.