Worksite screening for high blood cholesterol: implications for detection, evaluation and treatment--the Israel...

Current recommendations for optimal blood cholesterol levels could have major implications for the detection, evaluation and treatment of high blood cholesterol in Israel. During 1985-87, in the framework of the CORDIS Study, a sample of 3,556 males and 1,558 females, aged 20-64, employed in Israeli industry were screened at the worksite for lipids, lipoproteins and other cardiovascular risk factors. From the age-group 20-24 to 60-64 years, the prevalence of high blood cholesterol (greater than 239 mg/dl) increased from 1.6% to 34.3% for males and from 5.4% to 36.7% for females. Ethnic differences were present, with those from Western countries generally having the highest prevalence. When examined in two age-groups, 20-44 and 45-64 years respectively, 28.6% and 54% of males and 8.8% and 37.5% of females had a combination of cholesterol levels and coronary heart disease (CHD) risk factors for which lipoprotein analysis is currently recommended. There was an increase in the prevalence of high blood cholesterol with increased number of non-lipid CHD risk factors (for 0 to greater than or equal to 3 risk factors, age-adjusted prevalence ranged from 18.2 to 37.5% for males and 9.6% to 41.4% for females). Less than 5% of those with high blood cholesterol were aware of their condition, and less than 1% were under treatment. The prevalence of high blood cholesterol in the working population is Israel appears to be similar to that of the United States. Age-related changes in low density and high density lipoprotein cholesterol levels are such that monitoring of cholesterol in most people need not be more frequent than every 3-5 years. Any cholesterol screening program should be designed to allow for varying schedules according to age, sex and the presence of other risk factors for cardiovascular disease.