Contribution of a risk factor clinic to lipid management in patients with coronary artery disease.
The progress of a cohort of 145 patients seen between June 1986 and June 1989 was reviewed. These patients had treatment prescribed by the clinic and had data recorded over serial visits; they allowed us to determine the contribution of the risk factor clinic. Eighty-six percent had coronary artery disease. Patients were given nutritional advice, partly in groups. In addition 61% were treated with drug therapy. Seventy-four percent had modified their diet before the clinic visit but only 32% received less than 30% of energy from fat; the number rose to 67% by discharge. Sixty-four percent had a body mass index of 25 or greater, falling to 53% at discharge. Mean total cholesterol of the 145 patients was 7.9, HDL cholesterol 1.06, and total:HDL cholesterol ratio 7.7 mmol/L. Changes with clinic management were: total cholesterol -19%, HDL cholesterol +11%, total:HDL cholesterol ratio -25%, LDL cholesterol -21%. Despite these changes, levels were less than optimal for patients with coronary arterial disease in at least 50% of patients at the time of discharge. Improved results can be achieved only with a more aggressive approach to drug therapy. Recent studies in patients with coronary disease provide strong support for such a change in management.
Neutze
J
J
Green Lane Hospital, Auckland.
Cormack
B
B
Kerr
B
B
Pepper
L
L
Ramage
C
C
D015992:Body Mass Index; D001835:Body Weight; D002791:Cholesterol, Dietary / Q000008:administration & dosage* / Q000032:analysis; D008076:Cholesterol, HDL / Q000008:administration & dosage / Q000032:analysis / Q000097:blood; D008078:Cholesterol, LDL / Q000008:administration & dosage / Q000032:analysis / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood / Q000178:diet therapy* / Q000188:drug therapy; D003376:Counseling; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009520:New Zealand; D052756:Nutritional Sciences / Q000193:education*; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012307:Risk Factors
D002791:Cholesterol, Dietary; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL