Reddy E, Kreher N, Hickner J M
Northern Menominee Health Center, Powers, Michigan, USA.
J Fam Pract. 1998 Mar;46(3):227-32.
There has been much controversy in the medical literature regarding the benefit of treating elevated cholesterol levels in asymptomatic elderly people (65 years of age and older) to prevent coronary heart disease (CHD). Little has been published about the attitudes and beliefs of elderly patients regarding the importance of cholesterol levels to their health. This study seeks to describe the importance that elderly persons place on cholesterol in regard to heart disease, how worried they are about it, and what behavior changes they are making to control their own cholesterol levels.
We used a cross-sectional questionnaire to study elderly primary care patients in a rural setting with no personal history of coronary heart disease.
Six hundred eighty patient questionnaires were analyzed. Ninety-six percent of respondents believed high cholesterol to be at least moderately important for heart disease; 67% believed it to be very important. Fifty-nine percent were at least slightly worried about their own cholesterol level. Seventy-four percent said they had had their cholesterol checked within the past 2 years, and 66% had discussed their cholesterol level with their physician within the past 2 years. Sixty-six percent were trying to keep their cholesterol level down by dieting (42%), exercising (39%), or taking prescription medicine (15%).
Elderly patients who responded to this questionnaire are aware that hypercholesterolemia is a risk factor for CHD, and many eat a low-fat diet, exercise, or take prescription medication to lower their cholesterol. Physicians should be aware that many elderly patients without an established diagnosis of CHD are concerned about their cholesterol level. Physicians should be prepared to discuss with their elderly patients the potential advantages and disadvantages of the treatment of asymptomatic hypercholesterolemia.
医学文献中对于治疗无症状老年人（65岁及以上）的高胆固醇水平以预防冠心病存在诸多争议。关于老年患者对胆固醇水平对其健康重要性的态度和信念，相关报道较少。本研究旨在描述老年人对胆固醇与心脏病关系的重视程度、他们对此的担忧程度以及为控制自身胆固醇水平所采取的行为改变。
我们采用横断面问卷调查研究农村地区无冠心病个人史的老年初级保健患者。
共分析了680份患者问卷。96%的受访者认为高胆固醇对心脏病至少有一定重要性；67%认为非常重要。59%的人至少有点担心自己的胆固醇水平。74%的人表示在过去2年内检查过胆固醇，66%的人在过去2年内与医生讨论过自己的胆固醇水平。66%的人试图通过节食（42%）、锻炼（39%）或服用处方药（15%）来降低胆固醇水平。
对该问卷作出回应的老年患者意识到高胆固醇血症是冠心病的危险因素，许多人通过低脂饮食、锻炼或服用处方药来降低胆固醇。医生应意识到许多未确诊冠心病的老年患者担心自己的胆固醇水平。医生应准备好与老年患者讨论无症状高胆固醇血症治疗的潜在利弊。
