STUDY OF DYSLIPIDEMIA MANAGEMENT IN VETERANS WITH ATHEROSCLEROSIS (SECONDARY PREVENTION, LIPID MANAGEMENT).
Contributors: University of South Carolina.
Published: 1996
Number of pages: 122
Subjects: Health Sciences, Nursing.; Health Sciences, Medicine and Surgery.
Description: Scientific evidence has shown that dyslipidemia (altered plasma lipid levels) increases the risk of cardiovascular events, and that persons with atherosclerosis benefit from lipid-lowering therapy regardless of the initial lipid status. Benefits derived from the associated reduction in overall mortality, ischemia, myocardial infarction, revascularization procedures, arrhythmias, heart failure and other symptoms, and from improved general health, provide the rationale for implementing dyslipidemia management strategies. The purpose of this retrospective analysis of medical records was to describe patterns of dyslipidemia management in veterans with established atherosclerosis. To assess the transfer of empirical knowledge to practice, documented management patterns were compared to the American Heart Association (1995) guidelines for comprehensive risk reduction for persons with atherosclerosis.

The medical records of 315 veterans with definite coronary and/or atherosclerotic disease were examined. Demographic and clinical variables such as age, gender, race, hypertension, diabetes, diagnosis, and family history of coronary artery disease were obtained from patients' index medical record. Serum lipid levels, obesity, smoking, sedentary lifestyle, and interventions for the management of dyslipidemia were recorded for 2 specifically circumscribed time periods. Data were analyzed using descriptive statistics. Results indicated risk factors $\ge$3 in 95% and prior coronary events in 68%. Baseline serum LDL levels had been determined in only 56%. Of the 177 cases assessed for dyslipidemia, less than half (48%) were prescribed interventions as recommended by AHA guidelines. Within 6 months, 10.2% of the sample met the AHA primary goal for lipid management while only 3.2% met both primary and secondary goals. Lipid improvements between baseline and 6 months were found (using matched t tests) for serum total cholesterol, 235 and 206 mg/dl $(P < .0005),$ LDL 146 and 120 mg/dl $(P < .0005),$ and HDL 28.7 and 32.5 mg/dl $(P = .004),$ respectively. Findings from this study revealed an alarmingly low proportion of this high risk population received appropriate dyslipidemia management compared to the AHA recommended guidelines. These findings indicate that secondary preventive strategies guided by a nurse may be an appropriate approach.
Notes: Source: Dissertation Abstracts International, Volume: 57-11, Section: B, page: 6849.

Thesis (PH.D.)--UNIVERSITY OF SOUTH CAROLINA, 1996.

School code: 0202.