WINSTON-SALEM, N.C. -- In an era when many physicians believe that elderly patients are overmedicated, a new study in Winston-Salem and elsewhere finds that many elderly patients with high cholesterol levels are undertreated -- even those who had a history of coronary heart disease.
Investigators monitoring participants in the Cardiovascular Health Study (CHS) found that less than 20 percent of those eligible for drugs according to 1993 guidelines of the National Cholesterol Education Panel actually got them, said Curt Furberg, M.D., Ph.D., professor and chairman of the Department of Public Health Sciences at the Wake Forest University School of Medicine.
Furberg said he was concerned about the findings. He is national principal investigator of CHS, the largest study ever of the natural progression of heart disease and stroke in the elderly, and co-author of a report that appeared recently in the Archives of Internal Medicine.
Heart disease remains the leading cause of death for people over 65. Recent evidence suggests that elevated cholesterol levels remain a risk factor for death from coronary heart disease in the elderly in otherwise good health.
"Given the clinical trial evidence for benefit, those aged 65 to 75 years and with prior coronary heart disease appeared undertreated with cholesterol lowering drug therapy," the report concluded.
At the 1989 start of the Cardiovascular Health Study, sponsored by the National Heart, Lung and Blood Institute, 4.5 percent of the men and 5.9 percent of the women were using cholesterol-lowering drugs. By 1996, 8.1 percent of men and 10 percent of women were using the drugs. Though the study is ongoing, later figures are not available.
The Cardiovascular Health Study originally enrolled 5,201 men and women
over the age of 65 in Forsyth County (Winston-Salem), N.C., Washington County
(Hagerstown), Md., Allegheny County (Pittsburgh) Pa., and Sacrament
Contact: Robert Conn, Jim Steele or Mark Wright
Wake Forest University Baptist Medical Center