BACKGROUND: Siblings of individuals with premature @entity301 have a high prevalence of low-density lipoprotein @entity165 ( @entity11429 ) levels requiring treatment. OBJECTIVE: To evaluate management strategies for high @entity11429 levels in apparently healthy 30- to 59-year-old siblings of individuals with documented @entity301 prior to age 60 years. METHODS: In a 2-year trial of care provided by either a nurse trained in lipid management (NURS) or enhanced primary care (EPC), in which physicians received recommendations based on national guidelines, 156 siblings with @entity11429 levels of 4.14 mmol/L (160 mg/dL) were randomized by family. The @entity11429 goal levels below 3.36 mmol/L (130 mg/dL) were compared between and within intervention groups. Multiple logistic regression analyses were applied to predict 2-year achievement of the goal. RESULTS: The NURS group achieved a significantly greater percentage of goal @entity11429 levels than the EPC group (26% vs 10%; P=.008). The NURS @entity11429 levels decreased an average of 0.91 mmol/L (35 mg/dL) while EPC levels decreased by 0.52 mmol/L (24 mg/dL) (P=.09). In the final multivariate model, siblings taking lipid-lowering drug treatment were 6.02 times more likely (95% confidence interval, 2.24-16.18) than those not receiving pharmacotherapy to achieve @entity11429 goals; nurse management (P=.09) was marginally significant. Pharmacotherapy was instituted in 45.2% of NURS and 16.7% of EPC siblings (P=.001). CONCLUSIONS: High @entity11429 levels in siblings were more effectively treated by a trained nurse, probably related to greater adherence to the application of national guidelines. Nonetheless, the majority of siblings with high @entity11429 levels did not meet goal levels 2 years after an index case @entity301 event.

Nurse-mediated @entity165 management compared with enhanced primary care in siblings of individuals with premature XXXX .

@entity11429 :: ('22796', 'Gene') :: ['LDL-C'] @entity165 :: ('MESH:D002784', 'Chemical') :: ['cholesterol'] @entity301 :: ('MESH:D003327', 'Disease') :: ['coronary heart disease']
@entity301 :: (MESH:D003327,Disease) :: ['coronary disease']
