專題討論20:高血脂症治療面面觀
The Strategic Management of Hyperlipidemia

S20-3
台灣高血脂之治療現況
The Present status of Hyperlipidemia Management in Taiwan
何奕倫
台大醫學院臨床醫學研究所

The present prevalence of hypercholesterolemia (defined by serum total cholesterol ≧240mg/dl) is 10.8% for men and 10.9 %for women in Taiwan. The prevalence of hypercholesterolemia in different age group is as follows: 0.5% (<20 years old), 3.9% (20-29 years old), 6.0% (30-39 years old), 11.0% (40-49 years old), 18.3% (50-59 years old), 22.2% (60-69 years old), 20.7% (70-79 years old), 20.6% (>80 years old). The present prevalence of hypertriglyceridemia (defined by serum triglyceride≧200mg/dl) is 20.3% for men and 11.3 %for women in Taiwan. The prevalence of hypertriglyceridemia in different age group is as follows: 2.2% (<20 years old), 6.6% (20-29 years old), 14.1% (30-39 years old), 17.0% (40-49 years old), 20.8% (50-59 years old), 26.9% (60-69 years old), 26.0% (70-79 years old), 19.6% (>80 years old). The hyperlipidemia diagnosis treatment rate is as follows: 23.6% (20-29 years old), 45.4% (30-39 years old), 58.6% (40-49 years old), 73.6% (50-59 years old), 85.4% (60-69 years old), 85.5% (70-79 years old), 49.9% (>80 years old). According to the data of Taiwan Association of Diabetes Mellitus, the prevalence of low-density lipoprotein-cholesterol (LDL-C) <130 mg/dl in 7541 patients with type 2 daibetes mellitus is 33.4%. Taiwan Society of Cardiovascular Interventions has done a survey of LDL-C in patients with type 2 daibetes mellitus and cardiovascular disease. The prevalence of LDL-C <130 mg/dl after treatment for 18 months is 34.57%. A cross-sectional survey is implemented using the National Health Insurance Research Database between January 1997 and December 2003 for patients with type 2 diabetes mellitus and hyperlipidemia. Between 1997 and 2000, fibrates are the most widely prescribed major class of lipid lowering drugs, while the rates show a significant decline over time. The proportions of statin use increase 3.3-fold from 20.8% of all lipid lowering drugs in 1997 to 69.0% in 2003. With the continuous increase in the use of statins, they replaced fibrates as the most heavily used lipid lowering drugs by 2001.