How concerned are elderly patients without coronary heart disease about hypercholesterolemia and heart disease? An...

There has been much controversy in the medical literature regarding the benefit of treating elevated cholesterol levels in asymptomatic elderly people (65 years of age and older) to prevent coronary heart disease (CHD). Little has been published about the attitudes and beliefs of elderly patients regarding the importance of cholesterol levels to their health. This study seeks to describe the importance that elderly persons place on cholesterol in regard to heart disease, how worried they are about it, and what behavior changes they are making to control their own cholesterol levels.

We used a cross-sectional questionnaire to study elderly primary care patients in a rural setting with no personal history of coronary heart disease.

Six hundred eighty patient questionnaires were analyzed. Ninety-six percent of respondents believed high cholesterol to be at least moderately important for heart disease; 67% believed it to be very important. Fifty-nine percent were at least slightly worried about their own cholesterol level. Seventy-four percent said they had had their cholesterol checked within the past 2 years, and 66% had discussed their cholesterol level with their physician within the past 2 years. Sixty-six percent were trying to keep their cholesterol level down by dieting (42%), exercising (39%), or taking prescription medicine (15%).

Elderly patients who responded to this questionnaire are aware that hypercholesterolemia is a risk factor for CHD, and many eat a low-fat diet, exercise, or take prescription medication to lower their cholesterol. Physicians should be aware that many elderly patients without an established diagnosis of CHD are concerned about their cholesterol level. Physicians should be prepared to discuss with their elderly patients the potential advantages and disadvantages of the treatment of asymptomatic hypercholesterolemia.