Back to Browse Journals » Vascular Health and Risk Management » Volume 4 » Issue 5

Maintenance of improved lipid levels following attendance at a cardiovascular risk reduction clinic: a 10-year experience

Authors Glen J Pearson, Kari L Olson, Nicole E Panich, Sumit R Majumdar, Ross T Tsuyuki, et al

Published Date August 2008 Volume 2008:4(5) Pages 1127—1135

DOI http://dx.doi.org/10.2147/VHRM.S3748

Published 18 August 2008

Glen J Pearson1,5, Kari L Olson6, Nicole E Panich1, Sumit R Majumdar2,5, Ross T Tsuyuki1,4, Dawna M Gilchrist2,5, Ali Damani4, Gordon A Francis3,5

The MILLARR Study (Maintenance of Improved Lipid Levels Following Attendance at a Cardiovascular Risk Reduction Clinic) 1Department of Medicine, Divisions of Cardiology; 2General Internal Medicine; 3Endocrinology and Metabolism; Faculty of Pharmacy and Pharmaceutical Sciences; 4University of Alberta, Edmonton, Alberta, Canada; 5Cardiovascular Risk Reduction Clinic (CRRC), University of Alberta Hospital, Edmonton, Alberta, Canada; 6University of Colorado Health Sciences Center, Denver, Colorado, USA; 7Family Medicine (Private Practice), Calgary, Alberta, Canada

Background: Specialty cardiovascular risk reduction clinics (CRRC) increase the proportion of patients attaining recommended lipid targets; however, it is not known if the benefits are sustained after discharge. We evaluated the impact of a CRRC on lipid levels and assessed the long-term effect of a CRRC in maintaining improved lipid levels following discharge.

Methods: The medical records of consecutive dyslipidemic patients discharged >6 months from a tertiary hospital CRRC from January 1991 to January 2001 were retrospectively reviewed. The primary outcome was the change in patients’ lipid levels between the final CRRC visit and the most recent primary care follow-up. A worst-case analysis was conducted to evaluate the potential impact of the patients in whom the follow-up lipid profiles post-discharge from the CRRC were not obtained.

Results: Within the CRRC (median follow-up = 1.28 years in 1064 patients), we observed statistically significant improvements in all lipid parameters. In the 411 patients for whom post-discharge lipid profiles were available (median follow-up = 2.41 years), there were no significant differences observed in low-density lipoprotein-cholesterol, total cholesterol (TC), or triglycerides since CRRC discharge; however, there were small improvements in high-density lipoprotein-cholesterol (HDL-C) and TC:HDL ratio (p < 0.05 for both). The unadjusted worst-case analysis (653 patients with no follow-up lipid profiles) demonstrated statistically significant worsening of all lipid parameters between CRRC discharge and the most recent follow-up. However, when the change in lipid parameters between the baseline and the most recent follow-up was assessed in this analysis, the changes in all lipid parameters were significantly improved (p < 0.05).

Conclusions: This study demonstrates that a CRRC can improve lipid levels and suggests that these benefits are sustained once patients are returned to the care of their primary physician.

Keywords: cardiovascular risk factors, dyslipidemia, outcomes, pharmacotherapy, secondary prevention

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Enhanced photodynamic leishmanicidal activity of hydrophobic zinc phthalocyanine within archaeolipids containing liposomes [Corrigendum]

Perez AP, Casasco A, Schilrreff P, Defain Tesoriero MV, Duempelmann L, Pappalardo JS, Altube MJ, Higa L, Morilla MJ, Petray P, Romero EL

International Journal of Nanomedicine 2015, 10:169-170

Published Date: 29 December 2014

Postpartum depression on the neonatal intensive care unit: current perspectives

Tahirkheli NN, Cherry AS, Tackett AP, McCaffree MA, Gillaspy SR

International Journal of Women's Health 2014, 6:975-987

Published Date: 24 November 2014

Self-directed treatment for lower limb wounds in persons with diabetes: a short report

Harnarayan P, Cawich SO, Islam S, Ramsewak S, Naraynsingh V

Patient Preference and Adherence 2014, 8:1173-1177

Published Date: 2 September 2014

Visual field characteristics in neuromyelitis optica in absence of and after one episode of optic neuritis

Merle H, Olindo S, Jeannin S, Hage R, Donnio A, Richer R, Cabre P

Clinical Ophthalmology 2013, 7:1145-1153

Published Date: 11 June 2013

Comparison study of ferrofluid and powder iron oxide nanoparticle permeability across the blood–brain barrier

Hoff D, Sheikh L, Bhattacharya S, Nayar S, Webster TJ

International Journal of Nanomedicine 2013, 8:703-710

Published Date: 13 February 2013

Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D

Christiansen SM, Mifflin MD, Edmonds JN, Simpson RG, Moshirfar M

Clinical Ophthalmology 2012, 6:2109-2117

Published Date: 20 December 2012

Therapeutic effect of bortezomib for primary plasma cell leukemia followed by auto/allo stem cell transplantation

Ozasa R, Hotta M, Yoshimura H, Nakanishi T, Tamaki T, Fujita S, Nakamichi N, Miyaji M, Ishii K, Ito T, Nomura S

International Medical Case Reports Journal 2012, 5:39-43

Published Date: 6 July 2012

Influence of demographic and metabolic variables on forearm blood flow and vascular conductance in individuals without overt heart disease

Thiago E Sartori, Rafael AB Nunes, Gisela T da Silva, et al

Vascular Health and Risk Management 2010, 6:431-437

Published Date: 31 May 2010

A randomized trial assessing the clinical efficacy and microbial eradication of 1% azithromycin ophthalmic solution vs tobramycin in adult and pediatric subjects with bacterial conjunctivitis

Mark Abelson, Eugene Protzko, Aron Shapiro, Ana Garces-Soldana, Lyle Bowman, 1% azithromycin in DuraSite Clinical Study Group

Clinical Ophthalmology 2007, 1:177-182

Published Date: 5 October 2007