03489nas a2200433 4500008004100000022001400041245011000055210006900165260001600234300001000250490000800260520229000268653001602558653000902574653002202583653003002605653002102635653002102656653003002677653001102707653001102718653002502729653002502754653000902779653002302788653003002811653001702841653001802858100001702876700001702893700001402910700001502924700001702939700001602956700001502972700001702987700001603004856003503020 1992 eng d a0003-481900aEligibility for cholesterol referral in community-dwelling older adults. The Cardiovascular Health Study.0 aEligibility for cholesterol referral in communitydwelling older  c1992 Apr 15 a641-90 v1163 a

OBJECTIVES: To assess the proportion of community-dwelling adults aged 65 years or older who are eligible for referral for lipoprotein analysis and intervention according to the National Cholesterol Education Program (NCEP) guidelines.

DESIGN: Cross-sectional study based on examinations and questionnaires collected in 1989 and 1990.

SETTING: Four communities in the U.S. in the Cardiovascular Health Study (CHS), a study of risk factors for heart disease and stroke in older adults.

PARTICIPANTS: A sample of 4810 men and women ages 65 to 100 randomly selected and recruited from Health Care Financing Administration Medicare eligibility lists for the four communities; not institutionalized, not wheelchair-bound, not currently receiving therapy for cancer, not currently taking lipid-lowering medications, and not having eaten in the preceding 9 hours.

MEASUREMENTS: Total cholesterol and lipoprotein analysis measured in all participants.

RESULTS: Total cholesterol levels were less than 5.17 mmol/L (200 mg/dL) in 37% of participants, 5.17 to 6.19 mmol/L (200 to 239 mg/dL) in 39%, and 6.20 mmol/L (240 mg/dL) or greater in 24%. Compared with their counterparts, older participants, especially those over 80 years of age, were more likely to have levels below 5.17 mmol/L, as were men, nonwhites, and those with coronary heart disease or two or more coronary heart disease risk factors (P less than 0.008 for all values). Based on this screening measurement, 2174 participants were eligible for lipoprotein analysis, 80% were eligible for dietary or drug therapy using NCEP guidelines. Overall, 46% of CHS participants were eligible for lipoprotein analysis and 36% for intervention by NCEP guidelines, based on a single cholesterol measurement.

CONCLUSION: A substantial proportion of older adults in this community sample were eligible for lipoprotein analysis and intervention. Prospective studies of elderly persons are needed to determine the risk for incident coronary heart disease according to NCEP classifications and the benefits of lipid-lowering treatments in persons in this age group so that intervention strategies may best be targeted to an appropriately high-risk group.

10aAge Factors10aAged10aAged, 80 and over10aCerebrovascular Disorders10aCholesterol, LDL10aCoronary Disease10aEligibility Determination10aFemale10aHumans10aHypercholesterolemia10aLongitudinal Studies10aMale10aPrimary Prevention10aReferral and Consultation10aRisk Factors10aUnited States1 aManolio, T A1 aFurberg, C D1 aWahl, P W1 aTracy, R P1 aBorhani, N O1 aGardin, J M1 aFried, L P1 aO'Leary, D H1 aKuller, L H uhttps://chs-nhlbi.org/node/808