Prevalence of adequate and of optimal control of serum low-density lipoprotein cholesterol in an academic nursing home.
OBJECTIVE
To determine the prevalence of adequate control of serum low-density lipoprotein (LDL) cholesterol in older persons who were not terminally ill in an academic nursing home.


METHODS
An increased LDL cholesterol was 100 mg/dL or higher in very high-risk persons with coronary artery disease (CAD), ischemic stroke, peripheral arterial disease, diabetes mellitus, or 2+ risk factors and a 10-year risk for CAD greater than 20%; 130 mg/dL or higher in moderately high-risk persons with 2+ risk factors and a 10-year risk for CAD of 10% to 20%; and 160 mg/dL or higher in low risk persons with 0 to 1 risk factor.


METHODS
An academic nursing home.


METHODS
Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home.


METHODS
Prevalence of use of lipid-lowering drugs and of serum LDL cholesterol less than 100 mg/dL and less than 70 mg/dL in very high-risk persons and less than 130 mg/dL and less than 100 mg/dL in moderately high-risk persons.


RESULTS
Measurements of serum LDL cholesterol were obtained in 135 of 135 very high-risk persons (100%), in 57 of 61 moderately high-risk persons (93%), and in none of 6 low-risk persons (0%). Statins were used in 115 of 135 very high-risk persons (85%) and in 24 of 57 moderately high-risk persons (42%). Ezetimide was used to treat 3 of 135 very high-risk persons (2%). The last serum LDL cholesterol reported was less than 100 mg/dL in 119 of 135 very high-risk persons (93%), less than 70 mg/dL in 108 of 135 very high-risk persons (80%), less than 130 mg/dL in 40 of 57 moderately high-risk persons (70%), and less than 100 mg/dL in 35 of 57 moderately high-risk persons (61%).


CONCLUSIONS
Serum LDL cholesterol was measured in 192 of 202 older persons (95%) in an academic nursing home. Serum LDL cholesterol was adequately controlled in 93% of very high-risk persons and in 70% of moderately high-risk persons. Serum LDL cholesterol was optimally controlled in 80% of very high-risk persons and in 61% of moderately high-risk persons.
Koka
Madhavi
M
Department of Medicine, Division of Geriatrics, New York Medical College, Valhalla, NY 10595, USA.
Joseph
Julie
J
Aronow
Wilbert S
WS
D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood; D000069438:Ezetimibe; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D016491:Peripheral Vascular Diseases / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors
D000924:Anticholesteremic Agents; D001384:Azetidines; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069438:Ezetimibe