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More than 102 million American adults have total cholesterol levels at or above 200 mg/dl, and more than 35 million of these people have levels of 240mg/dl or higher. These levels may put them at higher risk for heart disease. Another 71 million U.S. adults have elevated levels of LDL, or “bad” cholesterol. To make matters worse, many people are unaware that their cholesterol is elevated since nearly 1 in 3 Americans have not been tested in the past 5 years.
September is National Cholesterol Education Month — a perfect time to promote cholesterol screening. The American Heart Association endorses the National Cholesterol Education Program (NCEP) guidelines for detection of high cholesterol: all adults ages 20 or older should have a fasting lipoprotein profile — which measures total cholesterol, LDL, HDL, and triglyceride levels — at least once every 5 years.
Data from the Behavioral Risk Factor Surveillance System (BRFSS) show a significant decline in the percentage of Alaska adults who report they have not had their blood cholesterol level checked in the past 5 years, from 41% in 1991 to 29% in 2009. The percentage of those tested who report being told their blood cholesterol was high decreased to 25% in the mid 1990s, but has since increased to 33%. Nationally, the percentage of adults who report not being tested in the past 5 years was 23% in 2009, and the percentage of those tested who report having high blood cholesterol was 35%.
In our state, men and rural, Alaska Native, low-income (below $25,000/year), and less-educated populations are less likely than other groups to report having had their blood cholesterol tested in the past 5 years. There are, however, no significant differences in prevalence of reported doctor-diagnosed high cholesterol among these groups.
While those living in Southeast Alaska are more likely to have gotten cholesterol screening than are those living in the Gulf Coast region, the only regional disparity in prevalence of high cholesterol is between adults in the Gulf Coast (39%) and adults in Fairbanks (31%) and Anchorage (28%) regions.
Efforts by the State of Alaska to increase cholesterol screenings in all populations include joining the Million Hearts initiative — a national effort to reduce the number of heart attacks by 1 million by 2017. Million Hearts aims to prevent heart disease and stroke through the following:
Improving access to effective care;
Improving the quality of care for the ABCS (Aspirin, Blood pressure, Cholesterol, Smoking);
Focusing clinical attention on the prevention of heart attack and stroke;
Motivating the public to lead a heart-healthy lifestyle; &
Improving the prescription of and adherence to appropriate medications for the ABCS.
Other cholesterol control efforts by collaborative partners include increased availability of screenings, promotion of screening events, and awareness campaigns. Participants in the Providence Alaska Healthy Hearts Program receive the standard heart health blood tests, as well as additional specialized blood testing as needed. The “Lab Tests on Demand” program offers a variety of blood tests at reasonable prices with no provider order or appointment necessary. In addition, the PAMC Health Information Library online tool contains information and resources about cholesterol.
Providence Health & Services Alaska (PHSA) also has funded health and wellness initiatives in the communities of Valdez, Seward, Kodiak, and Anchorage that include free biometric screenings (including cholesterol) and “Know Your Numbers” programs through community health networks like the Sound Wellness Alliance Network (SWAN) in Valdez.
Many clinics, hospitals, and healthcare providers throughout the State offer a variety of cholesterol screenings. There is also a test for familial hypercholesterolemia, a genetic condition that leads to high total cholesterol, and genetic mutations that cause an excess of LDL particles.
American Heart Association. Heart Disease and Stroke Statistics—2010 Update. Available on the American Heart Association Web site.
National Institutes of Health. ATP III Guidelines At-A-Glace Quick Desk Reference. NIH Publication No. 01-3305. May 2001.
Alaska Department of Health and Social Services. The Burden of Heart Disease and Stroke in Alaska: Mortality, Morbidity, and Risk Factors. Anchorage, AK: State of Alaska, Dept of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion; December 2009.
Centers for Disease Control and Prevention (CDC). Behavioral Risk Factor Surveillance System Survey Data. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Alaska (2009).
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