Identification of high risk relatives for coronary heart disease

Familial hypercholesterolaemia: pilot study to identify children at risk

AIMS

To evaluate a more effective method of identifying children with familial hypercholesterolaemia by screening a population at high risk.

METHODS

Domiciliary measurement of random cholesterol concentration was made in 200 children who were first or second degree relatives of subjects with premature onset coronary artery disease. Measurements were taken by a health visitor using a portable analyser.

RESULTS

Twelve new cases of familial hypercholesterolaemia were identified during the first nine months of the study. Random cholesterol concentrations were within the normal range (< 5.2 mmol/l) in 70.5% of samples tested. Forty two (21%) of patients tested had a borderline cholesterol (5.2-5.9 mmol/l) but 50% of these fell within the normal range when fasting capillary samples were analysed. Children with significant hypercholesterolaemia on random testing (concentrations of > 5.9 mmol/l) (8.5%) also had fasting venous blood assayed for high density lipoprotein (HDL) cholesterol and tri-glyceride in the laboratory. Results indicated that 6.5% of patients screened were at high risk of cardiovascular disease (ratio of total: HDL cholesterol of > 4.5), and 1% had a moderately increased risk (ratio 3.5-4.5).

CONCLUSIONS

Children with familial hypercholesterolaemia can be identified from a selected "high risk" population by measuring random capillary cholesterol concentration.

Cardiovascular risk modification in the college student: knowledge, attitudes, and behaviors

STUDY OBJECTIVES

To study knowledge, attitudes, and behaviors regarding cardiovascular risk in college students, and to delineate preferred modes of gaining further information.

DESIGN

Cross-sectional survey.

SETTING

Four-year public liberal arts college.

PARTICIPANTS

1,503 students returning a questionnaire (response rate of 60.4%).

RESULTS

Over 91% of respondents knew hypertension was a major cardiovascular risk factor. In addition, 90% identified smoking, 86.7% identified cholesterol level, and 72% identified exercise as additional factors. Under 16% reported that they smoked cigarettes, but only 33.5% exercised regularly. Only 32.9% had had cholesterol levels checked, with 19.2% knowing their values. Over 94% named doctors and nurses as desired sources of further information, yet only 23% said doctors had previously discussed prevention of heart disease with them.

CONCLUSIONS

General knowledge of cardiac risk factors is high among college students, yet actual behavior does not necessarily reflect assimilation of these concepts. Students seek health information from traditional sources. Primary care physicians have a unique opportunity to address these issues, especially in the pre-college physical examination.