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Nearly Half of Senior Citizens, Boomers Fail to Get
Needed Cholesterol Treatment
Feb. 7, 2006 - Even though treatment for
cholesterol disorders can reduce the risk of heart and blood vessel
disease by about 30 percent over five years, many at-risk baby boomers
and senior citizens, aren't getting adequate treatment, according to
researchers from Wake Forest University School of Medicine and
colleagues reporting in Circulation: Journal of the American Heart
Association.
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"In our study of middle-age and older adults with
no symptoms of cardiovascular disease, about a third had cholesterol
disorders that would require drug treatment under current guidelines.
Yet, only 54 percent of those who needed treatment were getting it,"
said lead author David Goff Jr., M.D., Ph.D.
"Under-treatment of cholesterol disorders is a
major public health challenge," said Goff.
The researchers also found that cholesterol control
was lowest in study participants who were at the highest risk of
developing heart vessel disease. Cholesterol disorders such as having
"good" cholesterol that is too low or "bad" cholesterol that is too high
are a major risk factor for cardiovascular disease, which is the
leading cause of death in the United States.
"Cardiovascular disease is a significant health
problem in this country and lipid-lowering therapy has been proven to
help prevent it," said Goff, a professor of public health sciences and
internal medicine at Wake Forest's School of Medicine, part of Wake
Forest University Baptist Medical Center. "Our research illustrates the
importance of improving the treatment and control of cholesterol
disorders and eliminating treatment disparities."
The data came from the Multi-Ethnic Study of
Atherosclerosis (MESA), a population-based study of 6,814 men and women
who had no known cardiovascular disease. Caucasian, Hispanic, Chinese
and African-American participant were recruited some six communities
(Forsyth County, Baltimore, Chicago, Los Angeles, northern Manhattan,
N.Y., and St. Paul, Minn.).
The study's main objective is to determine the
characteristics of early cardiovascular disease before symptoms
develop and how it progresses. The goal of the current analysis was to
learn more about the challenge of implementing cholesterol treatment
guidelines issued by the National Cholesterol Education Program.
For the study, researchers measured participants'
blood pressure, height, weight and cholesterol and asked them about
family history of heart attack, current smoking, and current
prescription drugs. Each participant's 10-year risk of developing
disease of the coronary arteries was calculated, and they were
classified as being low risk, moderate risk or high risk.
"We found that cholesterol disorders were common in
this population that is free of known cardiovascular disease," said
Goff. "And we found that cholesterol treatment and control is far from
optimal. The high-risk group had the lowest level of control and there
was evidence of gender and ethnic disparities in both treatment and
control."
Among participants with cholesterol disorders, men
were 20 percent less likely than women to be treated. Blacks and
Hispanics were less likely (15 percent and 20 percent, respectively)
than whites to be treated. The researchers believe that the gender and
ethnic disparities may be related both to access to care and the
tendency to seek health care.
Women are more likely than men to have health
insurance and are reported to seek health care services more often than
men, the researchers said. Blacks and Hispanics also have lower health
insurance coverage rates and poorer access to care.
"Our study showed that more research and quality
improvement programs are needed to optimize management of cholesterol
disorders," Goff said.
The study was funded by the National Heart, Lung
and Blood Institute. Co-researchers were Alain Bertoni, M.D., M.P.H.,
and Denise Bonds, M.D., M.P.H., from Wake Forest, Holly Kramer, M.D.,
M.P.H., from Loyola Medical Center, Roger Blumenthal, M.D., from Johns
Hopkins University School of Medicine, Michael Y. Tsai, Ph.D., from the
University of Minnesota, and Bruce Psaty, M.D., Ph.D., M.P.H., from the
University of Washington.
Wake Forest University Baptist Medical Center is an
academic health system comprised of North Carolina Baptist Hospital and
Wake Forest University Health Sciences, which operates the university's
School of Medicine. The system comprises 1,187 acute care, psychiatric,
rehabilitation and long-term care beds and is consistently ranked as one
of "America's Best Hospitals" by U.S. News & World Report.
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