Cholesterol Awareness and Treatment in Patients With Coronary Artery Disease Participating in Cardiac Rehabilitation

OBJECTIVES: To survey cholesterol management practices among patients with coronary artery disease enrolled and not enrolled in cardiac rehabilitation. BACKGROUND: The National Cholesterol Education Program (NCEP) initially established guidelines regarding cholesterol awareness and treatment in 1987. Serum cholesterol reduction is most effective for reducing cardiac events in patients with established coronary artery disease, yet surveys of cholesterol awareness and treatment have not included these patients. METHODS: Three hundred seventy-nine men and women with coronary artery disease were surveyed according to cholesterol awareness, serum cholesterol level, frequency of lipid-lowering medication use, and frequency of achievement of a serum total cholesterol < 5.2 mmol/L (200 mg/dL) corresponding the 1987 NCEP guidelines for coronary artery disease patients, which were in place at the time of the study survey. RESULTS: Overall, 72% of the patients were aware of their cholesterol level, with an average serum total cholesterol of 5 5 +/- 1.0 mmol/L (213 +/- 39 mg/dL). Use of lipid-lowering medication was 26%. Forty-three percent had a total cholesterol < 5.2 mmol/L (200 mg/dL). Patients enrolled in a long-term cardiac rehabilitation program demonstrated enhanced cholesterol awareness (78%), lower total cholesterol values (5.2 +/- 0.9 mmol/L 203 +/- 36 mg/dL), higher use of lipid-lowering the therapy (34%), and more frequent achievement of total serum cholesterol of < 5.2 mmol/L (200 mg/dL) (48%) compared to the other patient groups (all P < .05). CONCLUSIONS: Patients with coronary artery disease demonstrate relatively low rates of cholesterol awareness, lipid-lowering medication use, and achievement of total serum cholesterol < 5.2 mmol/L (200 mg/dL) corresponding to the 1987 NCEP guidelines. Participation in long-term cardiac rehabilitation is associated with enhancement of these rates. Further efforts to educate physicians and develop programs to optimize cholesterol management in patients with coronary artery disease are needed.