September 2013
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Cholesterol
Screening
More than 102 million
American adults have total cholesterol levels at or above 200 mg/dl, and more
than 35 million of these people have levels of 240mg/dl or higher. These levels
may put them at higher risk for heart disease. Another 71 million U.S. adults
have elevated levels of LDL, or “bad” cholesterol. To make matters worse, many
people are unaware that their cholesterol is elevated since nearly 1 in 3
Americans have not been tested in the past 5 years.[1]
September is National
Cholesterol Education Month — a perfect time to promote cholesterol screening. The
American Heart Association endorses the National Cholesterol Education Program
(NCEP) guidelines for detection of high cholesterol: all adults ages 20 or
older should have a fasting lipoprotein profile — which measures total
cholesterol, LDL, HDL, and triglyceride levels — at least once every 5 years.[2]
Data from the Behavioral
Risk Factor Surveillance System (BRFSS) show a significant decline in the
percentage of Alaska adults who report they have not had their blood
cholesterol level checked in the past 5 years, from 41% in 1991 to 29% in 2009.
The percentage of those tested who report being told their blood cholesterol was
high decreased to 25% in the mid 1990s, but has since increased to 33%.
Nationally, the percentage of adults who report not being tested in the past 5
years was 23% in 2009, and the percentage of those tested who report having high
blood cholesterol was 35%.[3]
In our state, men and rural,
Alaska Native, low-income (below $25,000/year), and less-educated populations
are less likely than other groups to report having had their blood cholesterol
tested in the past 5 years. There are, however, no significant differences in
prevalence of reported doctor-diagnosed high cholesterol among these groups.[4]
While those living in
Southeast Alaska are more likely to have gotten cholesterol screening than are
those living in the Gulf Coast region, the only regional disparity in
prevalence of high cholesterol is between adults in the Gulf Coast (39%) and
adults in Fairbanks (31%) and Anchorage (28%) regions.[4]
Efforts by the State
of Alaska to increase cholesterol screenings in all populations include joining
the Million Hearts initiative — a national effort to reduce the number of heart
attacks by 1 million by 2017. Million Hearts aims to prevent heart disease and
stroke through the following:
-
Improving
access to effective care;
-
Improving
the quality of care for the ABCS (Aspirin, Blood pressure, Cholesterol, Smoking);
-
Focusing
clinical attention on the prevention of heart attack and stroke;
-
Motivating
the public to lead a heart-healthy lifestyle; &
-
Improving
the prescription of and adherence to appropriate medications for the ABCS.
Other cholesterol control
efforts by collaborative partners include increased availability of screenings,
promotion of screening events, and awareness campaigns. Participants in the Providence
Alaska Healthy Hearts Program receive the standard heart health blood tests, as
well as additional specialized blood testing as needed. The “Lab Tests on
Demand” program offers a variety of blood tests at reasonable prices with no
provider order or appointment necessary. In addition, the PAMC Health
Information Library online tool contains information and resources about
cholesterol.
Providence Health
& Services Alaska (PHSA) also has funded health and wellness initiatives in
the communities of Valdez, Seward, Kodiak, and Anchorage that include free
biometric screenings (including cholesterol) and “Know Your Numbers” programs
through community health networks like the Sound Wellness Alliance Network
(SWAN) in Valdez.
Many clinics, hospitals, and healthcare providers throughout the State offer a variety of cholesterol screenings. There is also a test for familial hypercholesterolemia, a genetic
condition that leads to high total cholesterol, and genetic mutations that cause
an excess of LDL particles.
Sources:
-
American Heart
Association. Heart Disease and Stroke
Statistics—2010 Update. Available
on the American Heart Association Web site.
-
National
Institutes of Health. ATP III Guidelines At-A-Glace Quick Desk Reference. NIH
Publication No. 01-3305. May 2001.
-
Alaska
Department of Health and Social Services. The
Burden of Heart Disease and Stroke in Alaska: Mortality, Morbidity, and Risk
Factors. Anchorage, AK: State of Alaska, Dept of Health and Social
Services, Division of Public Health, Section of Chronic Disease Prevention and
Health Promotion; December 2009.
-
Centers for Disease Control and
Prevention (CDC). Behavioral
Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department
of Health and Human Services, Centers for Disease Control and Prevention, Alaska (2009).
More about cholesterol
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