Schucker B, Wittes J T, Santanello N C, Weber S J, McGoldrick D, Donato K, Levy A, Rifkind B M
Lipid Metabolism-Atherogenesis Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892.
Arch Intern Med. 1991 Apr;151(4):666-73.
The National Heart, Lung, and Blood Institute, Bethesda, Md, sponsored national telephone surveys of practicing physicians and the adult public in 1983, 1986, and 1990 to assess attitudes and practices regarding high serum cholesterol levels. Each time, approximately 1600 physicians and 4000 adults were interviewed. Trends show continuing change in medical practice and public health behavior relating to serum cholesterol. In 1990, physicians reported treating serum cholesterol at considerably lower levels than in 1986 and 1983. The median range of serum cholesterol at which diet therapy was initiated was 5.17 to 5.66 mmol/L (200 to 219 mg/dL) in 1990, down from 6.21 to 6.70 mmol/L (240 to 259 mg/dL) in 1986 and 6.72 to 7.21 mmol/L (260 to 279 mg/dL) in 1983. The median ranges for initiating drug therapy were 6.21 to 6.70 mmol/L (240 to 259 mg/dL) in 1990, 7.76 to 8.25 mmol/L (300 to 319 mg/dL) in 1986, and 8.79 to 9.28 mmol/L (340 to 359 mg/dL) in 1983. The number of adults who reported having had their cholesterol level checked rose from 35% to 46% to 65% in 1983, 1986, and 1990, respectively. Between 1983 and 1990, the number of adults reporting a physician diagnosis of high serum cholesterol increased from 7% to 16%; the number reporting a prescribed cholesterol-lowering diet increased from 3% to 9%. Reports of self-initiated diet efforts reached a high of 19% in 1986 and decreased to 15% in 1990 compared with 1% in earlier years. In 1990, over 90% of physicians reported awareness and use of the recommendations from the Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, and the public reported marked increases in awareness of dietary methods to lower serum cholesterol. These changes suggest educational gains; the data also suggest areas for continued cholesterol educational initiatives.
位于马里兰州贝塞斯达的美国国立心肺血液研究所于1983年、1986年和1990年发起了针对执业医师和成年公众的全国性电话调查，以评估对高血清胆固醇水平的态度和做法。每次调查大约采访1600名医师和4000名成年人。趋势表明，与血清胆固醇相关的医疗实践和公共卫生行为在持续变化。1990年，医师报告的治疗血清胆固醇水平比1986年和1983年低得多。1990年开始饮食治疗的血清胆固醇中位数范围为5.17至5.66毫摩尔/升（200至219毫克/分升），低于1986年的6.21至6.70毫摩尔/升（240至259毫克/分升）和1983年的6.72至7.21毫摩尔/升（260至279毫克/分升）。1990年开始药物治疗的中位数范围为6.21至6.70毫摩尔/升（240至259毫克/分升），1986年为7.76至8.25毫摩尔/升（300至319毫克/分升），1983年为8.79至9.28毫摩尔/升（340至359毫克/分升）。报告进行过胆固醇水平检查的成年人数量在1983年、1986年和1990年分别从35%升至46%再升至65%。1983年至1990年期间，报告被医师诊断为高血清胆固醇的成年人数量从7%增至16%；报告采用规定的降胆固醇饮食的人数从3%增至9%。自行开始饮食控制的报告比例在1986年达到19%的高点，1990年降至15%，而早些年为1%。1990年，超过90%的医师报告知晓并采用了《国家胆固醇教育计划成人高血胆固醇检测、评估和治疗专家小组报告》中的建议，公众报告对降低血清胆固醇的饮食方法的知晓率显著提高。这些变化表明教育取得了成效；这些数据也表明了胆固醇持续教育举措的方向。
