Secondary prevention and referral of elderly patients to a cardiovascular lipid service.
ARCH GERONTOL GERIAT
1 - 11.
The burden of cardiovascular disease in the elderly has increased interest in lipid profiles which retain associations with outcome except at extreme age and for which management has benefits at least in secondary prevention. The source, clinical and laboratory background of 90 male and 120 female consecutive referrals age > 70 years to a specialist cardiovascular lipid service have been analysed. Main sources were vascular surgery 47%, cardiology 9% and general practice 41% with 6% referred through routine health checks. Presenting lipids (mM: mean +/- S.D.) were: males: cholesterol 6.9 +/- 1.7, triglycerides 2.3 +/- 1.5, HDL 1.2 +/- 0.3; females: cholesterol 7.8 +/- 1.4, triglycerides 2.1 +/- 1.3, HDL 1.5 +/- 0.5, consistent with greater awareness of lipid-related problems in males but significant vascular disease in females. Secondary lipemia was defined in 131/210, 62.3% of patients (83 recognised before clinic presentation, 48 found at follow-up, mainly diabetes). Significant vascular disease was identified in 166/210 patients, significant other risk factors in another 35 patients. Levels of lipoprotein(a) were widely distributed for all groups, but elevated against population profiles for all groups with vascular disease. Referrals were monitored and not routinely accepted: reassuringly most then accepted were justified through atheroma-related disease and opportunities for secondary prevention, with little additional burden through untargeted routine health checks. Recognition of and management of secondary lipemia and obesity were however incomplete. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.
|Title:||Secondary prevention and referral of elderly patients to a cardiovascular lipid service|
|Keywords:||health services for the aged, lipoproteins, ischaemic heart disease, peripheral vascular disease, fibrinogen, lipoprotein(a), CORONARY HEART-DISEASE, MYOCARDIAL-INFARCTION, OLDER ADULTS, RISK FACTOR, CHOLESTEROL, HYPERCHOLESTEROLEMIA, PRAVASTATIN, LIPOPROTEIN(A), FIBRINOGEN, WOMEN|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)|
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