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:

A case-control proton magnetic resonance spectroscopy study confirms cerebellar dysfunction in benign adult familial myoclonic epilepsy

Long L, Song Y, Zhang L, Hu C, Gong J, Xu L, Long H, Zhou L, Zhang Y, Zhang Y, Xiao B

Neuropsychiatric Disease and Treatment 2015, 11:485-491

Published Date: 25 February 2015

Knowledge about COPD among users of primary health care services

Queiroz MC, Moreira MA, Jardim JR, Barbosa MA, Minamisava R, Gondim HD, Velasco FC, Penhavel MV

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:1-6

Published Date: 17 December 2014

Serum lipid profile and its association with hypertension in Bangladesh

Choudhury KN, Mainuddin AKM, Wahiduzzaman M, Islam SMS

Vascular Health and Risk Management 2014, 10:327-332

Published Date: 30 June 2014

The effect of chronic heart failure and type 2 diabetes on insulin-stimulated endothelial function is similar and additive

Falskov B, Hermann TS, Rask-Madsen C, Major-Pedersen A, Christiansen B, Raunsø J, Køber L, Torp-Pedersen C, Dominguez H

Vascular Health and Risk Management 2011, 7:771-776

Published Date: 19 December 2011

Depression in vascular pathologies: the neurologist's point of view

Moretti R, Bernobich E, Esposito F, Torre P, Antonello RM, De Angelis L, Bellini G

Vascular Health and Risk Management 2011, 7:433-443

Published Date: 12 July 2011

Anterior segment granuloma and optic nerve involvement as the presenting signs of systemic sarcoidosis

Marilita M Moschos, Yan Guex-Crosier

Clinical Ophthalmology 2008, 2:951-953

Published Date: 20 November 2008

Mechanisms of endothelial dysfunction in obstructive sleep apnea

Amy Atkeson, Sanja Jelic

Vascular Health and Risk Management 2008, 4:1327-1335

Published Date: 7 October 2008

Time-dependent alterations in serum NO concentration after oral administration of L-arginine, L-NAME, and allopurinol in intestinal ischemia/reperfusion

Amalia E Yanni, Eleutherios Margaritis, Nikolaos Liarakos, Alkisti Pantopoulou, Maria Poulakou, et al

Vascular Health and Risk Management 2008, 4:437-441

Published Date: 6 May 2008

Influence of albuminuria and glomerular filtration rate on blood pressure response to antihypertensive drug therapy

John M Flack, Karl Duncan, Suzanne E Ohmit, Ruth Quah, Xuefeng Liu, et al

Vascular Health and Risk Management 2007, 3:1029-1037

Published Date: 15 January 2007