Cholesterol levels are above target ranges

Cholesterol levels remain higher than recommended levels despite widespread education and greater availability of cholesterol-lowering medicines, according to researchers at the University of Rochester Medical Center, New York.

Thomas Pearson, professor and chair of the school's department of community and preventive medicine, and his colleagues surveyed 619 primary care physicians who were most likely to prescribe cholesterol-lowering products. Of the physicians' 5,601 patients who were undergoing treatment for high cholesterol, only 38% had low-density lipoprotein levels within the ranges recommended by the National Institutes of Health's National Cholesterol Education Program.

The researchers also discovered that successful treatment rates decreased as a patient's risk factors increased. Among patients with fewer than two risk factors for cardiovascular disease, 68% reached the recommended level of 160 mg/dL; among those with two or more risk factors, only 37% reached their goal; and among patients with coronary heart disease, a mere 18% reached the recommended level of 100 mg/dL.

"Many patients don't change their diet or get more exercise even when prompted by their physicians," said Pearson. "Sometimes doctors start a [patient on a] medication and then call a patient 'treated' even though the first dose may not be enough."

The study, which was funded by Parke-Davis and Pfizer Inc., also revealed discrepancies in cholesterol-lowering success rates along racial lines. While 18% of white patients with coronary heart disease and 21% of Hispanic patients with coronary heart disease met their target goals, their African American counterparts had only a 5% success rate.

Patients who had the greatest success rates were those who followed their physician's advice to exercise more or change their diet to include less saturated fat. PR