[Adherence to national guidelines for lipid management in a department of endocrinology].

Objectives: National guidelines for lipid management have been updated in March 2005 by the French Health Products Safety Agency (Afssaps). The objective of this study was to assess clinical practices based on these recommendations in a department of endocrinology specialized in the management of dyslipidemic patients.

Materials And Methods: A sample of patients was independently selected among those referred to our outpatient clinic for assessment of hyperlipidemia.

[Chronic renal insufficiency and cardiovascular disease].

Renal insufficiency is frequently seen in patients with cardiovascular disease. In contrast, coronary artery disease is the leading cause of death in patients with renal impairment. The recognition of renal insufficiency is essential in these patients and preventive measures must be put in place to prevent the progression or onset of cardiovascular disease.

Hypothyroidism is not associated with increased carotid atherosclerosis when cardiovascular risk factors are accounted for in hyperlipidemic patients.

Overt hypothyroidism is associated with an increased prevalence of cardiovascular heart disease (CHD). The role of subclinical hypothyroidism as risk factor for cardiovascular diseases is supported by recent meta-analysis. However it still remains to be established whether hypothyroidism favors atherosclerosis independently of its effects on cardiovascular risk factors, such as hypercholesterolemia or hypertension.

[Subclinical hypothyroidism: a cardiovascular risk factor?].

Although patent hypothyroidism is clearly associated with increased cardiovascular risk, the relationship between infraclinical hypothyroidism and cardiovascular disease remains controversial though probable. This relationship is mediated by the traditional risk factors (lipids, hypertension), by changes in parameters of inflammation and haemostasis, and by a direct effect of thyroid hormones on the vessel wall. The authors review the epidemiological evidence and the mechanisms underlying the association between infraclinical hypothyroidism and cardiovascular risk and the therapeutic implications of this association.