[Quality of treatment in hypercholesterolemia in ambulatory patients]

In 1989 serum cholesterol was determined as a routine procedure in 534 consecutive patients. The response of the physicians to elevated cholesterol levels and factors associated with a treatment decision were analyzed. A follow-up was obtained in treated patients after at least one year. 105 patients (20%) had hypercholesterolemia, 84 of whom were available for evaluation; only in 34 (40%) was treatment initiated. Patients were more likely to be treated (p less than 0.05) if they had cholesterol greater than 1 mmol/l above normal, if they were between 41 and 50 years old, and if cholesterol had been determined at the physician's special request. The decision to treat was not influenced by sex, presence of further risk factors or by manifest atherosclerosis. After one year, 11 of 26 patients were still well controlled and treated. Their mean cholesterol level was significantly lower as compared to pretreatment levels. We conclude that initial as well as long-term management of patients with hypercholesterolemia should be improved.