Change in cholesterol awareness and action: Results from national physician and public surveys
The National Cholesterol Education Program was established in 1985 by the National Heart, Lung, and Blood Institute (NHLBI) to increase public and physician awareness of the importance of high blood levels of cholesterol as risk factors for coronary heart disease. The NHBLI has sponsored three extensive surveys, in 1983, 1986, and 1990, to gauge physician and public knowledge of cholesterol. The results of the 1990 survey have been tabulated and compared with the earlier studies. Current standards suggest that a desirable cholesterol level is 200 or less (measured in terms of milligrams per deciliter of blood), that borderline levels are 200 to 239, and that high levels are greater than 240. In the 1990 survey, physicians reported instituting dietary treatment for elevated cholesterol at levels of 200 to 219, which was much lower than in the earlier surveys. Drug therapy was generally instituted by physicians at levels of 240 to 260, also lower than in previous years. In 1990, 93 percent of the public reported having heard of high serum cholesterol, as compared with 77 percent in 1983 and 81 percent in 1986. Recognizing a level of below 200 as desirable was reported by 65 percent of the public in 1990, as compared with 16 percent in 1983. The number of people who reported having had their cholesterol checked had nearly doubled, from 35 percent in 1983 to 65 percent in 1990. Greater understanding of nutritional facts was demonstrated by the public in 1990 than in earlier years. Information about cholesterol has been made widely available to both physicians and patients in the seven years since the first survey was done, both through the educational project and the media in general. Both physicians and patients believe that all Americans should reduce their level of cholesterol. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Cholesterol measurement in children
Both a population approach and a patient-based approach to lowering blood cholesterol levels and the risk of heart disease should be implemented. The population or public health approach is to promote a diet lower in saturated fat, total fat and cholesterol. It is a cheap strategy and does not label anyone as having a disease. The patient-based approach is to identify and treat children who have high blood cholesterol and are likely to have heart disease as adults. The National Cholesterol Education Program recommends cholesterol screening for children whose parents or grandparents developed coronary heart disease before age 55 or have high blood cholesterol. Following these criteria would entail screening about 25% of all children over the age of two.
Publication Name: American Journal of Diseases of Children
When Should Patients With Heterozygous Familial Hypercholesterolemia Be Treated?
More research is needed to determine whether drugs that lower cholesterol levels will be effective in children. Hereditary hypercholesterolemia is a common genetic disease. The high levels of low-density lipoprotein, or `bad' cholesterol (LDL-C) can cause coronary artery disease fairly early in life. A 1999 study found that children with this condition who were treated with lovastatin were able to lower their blood cholesterol levels with few serious side effects. However, the children were not followed very long and more subtle defects may have been missed. Boys in particular might benefit from treatment.
Publication Name: JAMA, The Journal of the American Medical Association
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