A retrospective chart review was conducted on 331 V.A. outpatients with coronary heart disease (CHD) to identify predictors of achievement/maintenance of mean LDL cholesterol £100 mg/dl during two six-month study periods in 1998 and 1999. Data were collected on demographic/clinical variables, including co-morbid risk factor combinations (diabetes, hypertension, overweight/obesity, tobaccoism).
Fifty-three percent of the study population sustained mean LDL cholesterol £100 mg/dl (Group 1), while 10% increased to > 100 mg/dl during the study periods (Group 2). Nineteen percent improved mean LDL cholesterol to £100 mg/dl (Group 3), while 18% sustained levels > 100 mg/dl during the study periods (Group 4).
Multiple logistic regression analyses: In comparing Groups 1 and 2, predictors of Group 1 membership included medication compliance, more co-morbid medications (both p=.08), fewer titrations of cholesterol medications (p < .01) and absence of new prescriptions for beta-blockers (p=.04). In comparing Groups 1 and 4, predictors of Group 1 membership included more co-morbid medications, fewer titrations of cholesterol medications and absence of diabetes/BMI ³ 30 (all p < .01). In comparing Groups 3 and 4, Group 3 predictors included fewer titrations of cholesterol medications, and absence of diabetes/BMI ³30 and tobaccoism/BMI ³25 (all p £.05).
The results indicate that medication compliance and the presence of multiple co-morbid conditions can influence achievement/maintenance of LDL cholesterol £100 mg/dl. More intensive follow-up is recommended to optimize serum lipids, minimize co-morbid risk factor condition effects and to facilitate adoption of positive health behaviors.
Learning Objectives: After viewing the poster presentation, the participants will be able to: 1. Recognize the prevalence of co-morbid risk factors conditions (diabetes, hypertension, overweight/obesity, tobaccoism)among Veteran outpatients with CHD. 2. Describe the proportion of CHD patients enrolled in a VA outpatient cardiology clinic who are able to sustain LDL cholesterol at the National Cholesterol Education Program Goal (less than or equal to 100 mg/dl)during two study periods during 1998 and 1999 and compare this group to those unable to achieve/sustain LDL cholesterol at this goal. 2. Identify factors which impact upon the CHD patient's ability to achieve/maintain LDL cholesterol at the National Cholesterol Education Program Goal
Keywords: Heart Disease, Veterans' Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Dwight D. Eisenhower, Dept. of Veterans Affairs Medical Center, Leavenworth, KS: Care Clinic 3 Cardiology Outpatients
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.