NYMC Faculty Publications

Prevalence of Adequate and of Optimal Control of Serum Low-Density Lipoprotein Cholesterol in an Academic Nursing Home

Author Type(s)

Faculty

Journal Title

Journal of the American Medical Directors Association

First Page

604

Last Page

606

Document Type

Article

Publication Date

11-1-2007

Department

Medicine

Abstract

OBJECTIVE: To determine the prevalence of adequate control of serum low-density lipoprotein (LDL) cholesterol in older persons who were not terminally ill in an academic nursing home.

DESIGN: An increased LDL cholesterol was 100 mg/dL or higher in very high-risk persons with coronary artery disease (CAD), ischemic stroke, peripheral arterial disease, diabetes mellitus, or 2+ risk factors and a 10-year risk for CAD greater than 20%; 130 mg/dL or higher in moderately high-risk persons with 2+ risk factors and a 10-year risk for CAD of 10% to 20%; and 160 mg/dL or higher in low risk persons with 0 to 1 risk factor.

SETTING: An academic nursing home.

PARTICIPANTS: Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home.

MEASUREMENTS: Prevalence of use of lipid-lowering drugs and of serum LDL cholesterol less than 100 mg/dL and less than 70 mg/dL in very high-risk persons and less than 130 mg/dL and less than 100 mg/dL in moderately high-risk persons.

RESULTS: Measurements of serum LDL cholesterol were obtained in 135 of 135 very high-risk persons (100%), in 57 of 61 moderately high-risk persons (93%), and in none of 6 low-risk persons (0%). Statins were used in 115 of 135 very high-risk persons (85%) and in 24 of 57 moderately high-risk persons (42%). Ezetimide was used to treat 3 of 135 very high-risk persons (2%). The last serum LDL cholesterol reported was less than 100 mg/dL in 119 of 135 very high-risk persons (93%), less than 70 mg/dL in 108 of 135 very high-risk persons (80%), less than 130 mg/dL in 40 of 57 moderately high-risk persons (70%), and less than 100 mg/dL in 35 of 57 moderately high-risk persons (61%).

CONCLUSION: Serum LDL cholesterol was measured in 192 of 202 older persons (95%) in an academic nursing home. Serum LDL cholesterol was adequately controlled in 93% of very high-risk persons and in 70% of moderately high-risk persons. Serum LDL cholesterol was optimally controlled in 80% of very high-risk persons and in 61% of moderately high-risk persons.

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