The surveillance of cholesterol management in the cardiac rehabilitation setting

To evaluate the secondary prevention of coronary heart disease in the cardiac rehabilitation setting by quantifying the percentage of patients on lipid lowering therapy, the percentage of patients who have received diet counseling, and the percentage of patients with a lipid panel documented by discharge.

The Web-based database of the Wisconsin Society for Cardiovascular and Pulmonary Rehabilitation, representing 1477 patients, was examined for patient outcomes. A survey was sent to programs to assess the processes in place to assist patients in managing cholesterol and reaching a low-density lipoprotein (LDL-C) goal of less than 100 mg/dL.

Most patients were taking cholesterol medications (median, 70.9%; 95% confidence interval [CI], 63.9-80.9). A minority of patients had an LDL-C at the goal level (median, 42.6%; 95% CI, 27.7-58.6), and a few patients had received individual dietary counseling from a registered dietitian (median, 17.9%; 95% CI, 4.8-56.2). The survey indicated that although all programs made an effort to determine cholesterol levels at cardiac rehabilitation entry, only one half of the programs required a lipid panel at discharge also.

There is a high degree of variation among cardiac rehabilitation programs in terms of surveillance and treatment of dyslipidemias for patients with coronary heart disease.