Giles W H, Anda R F, Jones D H, Serdula M K, Merritt R K, DeStefano F
Cardiovascular Health Studies Branch, Centers for Disease Control and Prevention, Atlanta, Ga 30341-3724.
JAMA. 1993 Mar 3;269(9):1133-8.
To investigate recent trends in the percentage and characteristics of patients being treated by a physician for high blood cholesterol (HBC) and to assess missed clinical opportunities to screen for HBC.
DESIGN, SETTING, PARTICIPANTS: Telephone interviews of 154,735 adults in 37 states that participated in the Behavioral Risk Factor Surveillance System during 1988-1990 to assess trends in the percentage of patients treated for HBC by a physician. An opportunity was considered missed if a person did not report being screened for HBC despite seeing a physician for preventive care in the last 2 years.
Between the first quarter of 1988 and the last quarter of 1990, the percentage of persons treated by a physician for HBC increased from 7.6% to 11.7% (P < .001). However, since an estimated 36% of US adults need treatment for HBC, fewer than one third of persons who need treatment are receiving it. Persons with two or more cardiac risk factors were more likely to be treated, while men, blacks, persons in lower socioeconomic groups, and persons between 20 and 34 years of age were less likely to be treated. Among the 126,571 persons who had seen a physician for preventive care within the last 2 years, missed opportunities to screen for HBC were most common among persons aged 20 through 34 years (59%) and among women who had seen obstetricians/gynecologists for preventive care (43%).
Fewer than one third of persons who need treatment for HBC as estimated by data from the second National Health and Nutrition and Nutrition Examination Survey are receiving treatment. Better use of clinical opportunities to screen for HBC could substantially accelerate the progress in identifying persons, young adults in particular, who are likely to benefit from cholesterol reduction.
调查医生治疗高血胆固醇（HBC）患者的百分比及特征的近期趋势，并评估筛查HBC时错失的临床机会。
设计、场所、参与者：对1988 - 1990年期间参与行为危险因素监测系统的37个州的154,735名成年人进行电话访谈，以评估医生治疗HBC患者百分比的趋势。如果一个人在过去两年内接受过预防性医疗就诊，但未报告接受过HBC筛查，则认为存在错失机会。
在1988年第一季度至1990年最后一个季度期间，医生治疗HBC的患者百分比从7.6%增至11.7%（P <.001）。然而，由于估计有36%的美国成年人需要治疗HBC，因此接受治疗的患者不到需要治疗人数的三分之一。有两种或更多心脏危险因素的人更有可能接受治疗，而男性、黑人、社会经济地位较低的人群以及20至34岁的人群接受治疗的可能性较小。在过去两年内接受过预防性医疗就诊的126,571人中，20至34岁的人群（59%）以及因预防性医疗就诊而看过妇产科医生的女性（43%）中，错失HBC筛查机会的情况最为常见。
根据第二次全国健康和营养检查调查数据估计，需要治疗HBC的患者中接受治疗的不到三分之一。更好地利用临床机会筛查HBC可大幅加速识别可能从降低胆固醇中获益的人群（尤其是年轻人）的进程。
