Management of elevated serum cholesterol in a university-based family practice

Hypercholesterolemia is a well-known risk factor of coronary heart disease. This study was designed to determine whether a group of family physicians in an academic medical center followed recent recommendations in the recognition and treatment of young patients with elevated cholesterol levels. Patient charts were reviewed retrospectively in 94.1 percent of the 1,129 patients aged between 30 and 39 years seen in the University of California at Los Angeles (UCLA) Family Health Center over a one-year period. Only 346, or 32.6 percent, of the charts reviewed contained the patient's cholesterol values. Ninety-nine patients had serum cholesterol levels greater than the recommended treatment level of 5.70 mmol/L (220 mg/dL). Of patients with elevated cholesterol levels, only 34.1 percent were treated. There was no difference in the treatment rates of faculty members' patients as compared with residents' patients. The incidence of treatment increased linearly with respect to rising cholesterol values. This study identified the relative infrequency with which cholesterol levels appear in the charts of patients aged 30 to 39 years. It also illustrated that significantly more physician effort is required to meet suggested treatment guidelines for patients with elevated cholesterol levels. The cholesterol "normal ranges" that are reported on laboratory result sheets, which are not age-specific, may be misleading, and consequently affect patient care.