Prevalence of hypercholesterolemia among siblings of persons with premature coronary heart disease - Application of the second Adult Treatment Panel guidelines

被引:19
作者
Allen, JK
Young, DR
Blumenthal, RS
Moy, TF
Yanek, LR
Wilder, L
Becker, LC
Becker, DM
机构
[1] JOHNS HOPKINS UNIV, SCH MED, CTR HLTH PROMOT, BALTIMORE, MD 21205 USA
[2] JOHNS HOPKINS UNIV, SCH MED, DIV CARDIOL, BALTIMORE, MD 21205 USA
关键词
D O I
10.1001/archinte.156.15.1654
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Increased blood cholesterol, specifically high low-density lipoprotein cholesterol, increases risk for coronary heart disease (CHD). Persons with a positive family history of premature CHD also are at markedly increased risk. Objective: To examine the prevalence of hypercholesterolemia based on the second report of the National Cholesterol Educational Program Adult Treatment Panel (ATP II) guidelines in the asymptomatic healthy siblings of people with premature CHD. Methods: A total of 668 asymptomatic healthy siblings (354 men and 314 women) underwent screening for risk factors for CHD. Siblings were categorized into treatment categories for primary prevention defined by ATP II. The percentage who were candidates for intervention were compared with the published national estimates for those without CHD from the third National Health and Nutrition Examination Survey (NHANES III). Results: Based on ATP II guidelines, 65% of the asymptomatic adult siblings required fasting lipoprotein analysis compared with 33% of adults without CHD in the national reference population. Of the siblings who met the criteria for fasting lipoprotein analysis, most (56%) were candidates for dietary therapy, more than twice the proportion of adults from NHANES III. The percentage of the siblings who qualified for drug intervention and dietary therapy was 3 times greater than the national sample, 33% vs 11%, respectively. Assuming a 10% hypothetical reduction in low-density lipoprotein cholesterol levels as the result of dietary modification, the proportion of the sibling sample who were possible candidates for drug therapy was 20%, still 4 times that predicted for the national sample. Conclusions: These results underscore the need for aggressive detection and treatment of hypercholesterolemia in this easily identifiable high-risk population of siblings of people with premature CHD.
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页码:1654 / 1660
页数:7
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共 31 条
[21]  
RIFKIND BM, 1983, ATHEROSCLEROSIS, V6, P306
[22]   FAMILIAL OCCURRENCE OF CORONARY HEART-DISEASE - EFFECT OF AGE AT DIAGNOSIS [J].
RISSANEN, AM .
AMERICAN JOURNAL OF CARDIOLOGY, 1979, 44 (01) :60-66
[23]   GETTING CARDIOLOGISTS INTERESTED IN LIPIDS [J].
ROBERTS, WC .
AMERICAN JOURNAL OF CARDIOLOGY, 1993, 72 (09) :745-745
[24]   THE PREVALENCE OF HIGH BLOOD CHOLESTEROL LEVELS AMONG ADULTS IN THE UNITED-STATES [J].
SEMPOS, C ;
FULWOOD, R ;
HAINES, C ;
CARROLL, M ;
ANDA, R ;
WILLIAMSON, DF ;
REMINGTON, P ;
CLEEMAN, J .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1989, 262 (01) :45-52
[25]   PREVALENCE OF HIGH BLOOD CHOLESTEROL AMONG UNITED-STATES ADULTS - AN UPDATE BASED ON GUIDELINES FROM THE 2ND REPORT OF THE NATIONAL-CHOLESTEROL-EDUCATION-PROGRAM ADULT TREATMENT PANEL [J].
SEMPOS, CT ;
CLEEMAN, JI ;
CARROLL, MD ;
JOHNSON, CL ;
BACHORIK, PS ;
GORDON, DJ ;
BURT, VL ;
BRIEFEL, RR ;
BROWN, CD ;
LIPPEL, K ;
RIFKIND, BM .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (23) :3009-3014
[26]   BLOOD CHOLESTEROL TREATMENT ATTITUDES OF COMMUNITY PHYSICIANS - A MAJOR PROBLEM [J].
SUPERKO, HR ;
DESMOND, DA ;
DESANTOS, VV ;
VRANIZAN, KM ;
FARQUHAR, JW .
AMERICAN HEART JOURNAL, 1988, 116 (03) :849-855
[27]   FAMILIAL AGGREGATION OF CORONARY HEART-DISEASE AND ITS RELATION TO KNOWN GENETIC RISK-FACTORS [J].
TENKATE, LP ;
BOMAN, H ;
DAIGER, SP ;
MOTULSKY, AG .
AMERICAN JOURNAL OF CARDIOLOGY, 1982, 50 (05) :945-953
[28]   INTERNISTS ATTITUDES ABOUT CLINICAL-PRACTICE GUIDELINES [J].
TUNIS, SR ;
HAYWARD, RSA ;
WILSON, MC ;
RUBIN, HR ;
BASS, EB ;
JOHNSTON, M ;
STEINBERG, EP .
ANNALS OF INTERNAL MEDICINE, 1994, 120 (11) :956-963
[29]  
VIVIER PM, 1988, J FAM PRACTICE, V27, P167
[30]   NATURE, NURTURE, AND FAMILY PREDISPOSITION [J].
WILLIAMS, RR .
NEW ENGLAND JOURNAL OF MEDICINE, 1988, 318 (12) :769-771