Please select the eligibility criteria that correspond to the clinical trial below.
Title: Center for Advancing Equity in Clinical Preventive Services Project 2: Reducing Disparities in Primary Prevention of Cardiovascular Disease
Brief Summary: Cardiovascular disease (CVD) is the leading cause of disparities in years of life lost by race and low socioeconomic status. Statins have been shown to decrease the risk of cardiovascular events among individuals with high CVD risk. Yet, despite increased statin use and overall declining CVD rates, disparities in statin use and disparities in the control of high cholesterol by race, ethnicity, and socioeconomic status have persisted.

Objective: To improve the appropriate use of statins for primary cardiovascular disease prevention among high risk individuals at community health centers through a system of population health management that uses electronic health record (EHR) data to identify patients for targeted education and outreach.

Aim 1: Conduct a randomized controlled trial among individuals with 10-year risk for myocardial infarction or coronary death of 10% or higher to determine if the population health management intervention, compared to usual care, results in higher rates of documented statin treatment discussions within 6 months (primary process outcome), higher rates of statin prescribing within 6 months (secondary process outcome), and higher rates of significant low-density lipoprotein cholesterol (LDL-C) lowering defined as a follow up LDL-C ≥30 mg/dL lower than baseline (primary clinical outcome).

Aim 2: Interview patients who received the intervention to identify barriers to success

Aim 3: Assess the overall costs of the intervention and the costs per each patient who achieves significant LDL-C lowering compared to patient who received usual care.


Options:
A: Inclusion Criteria:

* All citizens in a predefined area

Exclusion Criteria:

* Drug abuse
* Language problem
B: Inclusion Criteria:

* men \>= 35 and women \>= 45 years old
* LDL-C completed in the past 5 years
* Not currently prescribed lipid lowering medication
* \>= 1 face to face visit to a study site in the 6 months prior to the start of the study or a visit during the enrollment period
* The 10-year risk of coronary death or myocardial infarction (based on Framingham Risk Score) is at least 10% and the LDL-C is above 100 mg/dL

Exclusion Criteria:

* Previously diagnosed with any of the following: coronary disease, peripheral arterial disease, carotid artery disease, abdominal aortic aneurysm, or diabetes mellitus
* Primary language is not English or Spanish
C: Inclusion Criteria:

* African American
* Uncontrolled Hypertension
* at least 3 practice visits in the past 2 years
* One lipid panel since 2005

Exclusion Criteria:

* No recent lipid panel
* Kept less than 60% of primary care visits in the prior 2 years
D: Inclusion Criteria:

* English speakers age 55 or greater
* Must have a medical history of at least one of the following:
* Coronary artery disease
* Myocardial infarction
* Stroke
* Transient Ischemic Attack
* Atrial Fibrillation
* Systolic heart failure
* Peripheral vascular disease/claudication
* Carotid artery disease
* Diabetes with either: Low density lipoprotein (LDL) 100 or greater AND/OR systolic blood pressure 140 or higher or diastolic blood pressure 90 or higher

Exclusion Criteria:

* Signs of acute angina, stroke, heart failure or renal failure
* Systolic blood pressure 200 or greater or diastolic blood pressure 115 or greater
* Significant hepatic disease, including: Cirrhosis, Hepatitis B or C infection, Alanine Aminotransferase (ALT) or Aspartate Aminotransferase (AST) 3 times control or higher, or total bilirubin 2.0 mg/dl or higher

Answer: B