title: Coronary care physician 1994-2000 adherence to 1993 National Cholesterol Education Program diet and lipid recommendations.
abstract: The 1993 NCEP recommended phase 2 diets and < or = 100 mg/dL LDL goals for all atherosclerotic patients. We reviewed Washington, DC physician 1994-2000 use of these recommendations for coronary care unit (CCU) patients. Questionnaires, chart reviews and interviews of cardiologists, residents and dietitians showed > 80% of CCU physicians ignored NCEP dietary recommendations. NCEP 1 diets were ordered for approximately 80% of patients. NCEP 2, AHA 3 or vegetarian diets were used for < 20%. Statins were reported for approximately 25% of patients in 1994-95 but were on < 20% of charts in 1996-7. This increased to approximately 58% by 2000. NCEP 2 diets lower cholesterol approximately 5%, rarely reaching LDL goals, and < 20% of CHD patients on anti-lipid therapy were at NCEP LDL goals by 1999. With 1-year post-myocardial infarction 34% mortality and 53% readmission rates, we need early and much more aggressive anti-lipid diets and drugs in treating these patients.
authors.affiliation: D.C. General Hospital, 1900 Massachusetts Ave. SE, Washington, DC 20003, USA.
authors.forename: T
authors.initials: T
authors.lastname: Banks
authors.forename: N
authors.initials: N
authors.lastname: Ali
mesh_terms: D001161:Arteriosclerosis / Q000178:diet therapy / Q000188:drug therapy / Q000517:prevention & control*; D002309:Cardiology; D004032:Diet; D018450:Disease Progression; D019983:Guideline Adherence; D006801:Humans; D006949:Hyperlipidemias / Q000517:prevention & control; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008403:Mass Screening / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000960:Hypolipidemic Agents