Cholesterol Management in the United States: The National Health and Nutrition Examination Survey, 1999 to 2006

Lower Dietary Magnesium Is Associated with a Higher Hemoglobin Glycation Index in the National Health and Nutrition Examination Survey

The data for the effect of dietary magnesium (Mg) on hemoglobin glycation index (HGI) is limited. Thus, this study aimed to examine the relationship between dietary Mg and HGI in the general population. Our research used data from the National Health and Nutrition Examination Survey from 2001 to 2002. The dietary intake of Mg was assessed by two 24-h dietary recalls. The predicted HbA1c was calculated based on fasting plasma glucose. Logistic regression and restricted cubic spline models were applied to assess the relationship between dietary Mg intake and HGI. We found a significant inverse association between dietary Mg intake and HGI (β =  - 0.00016, 95%CI: - 0.0003, - 0.00003, P = 0.019). Dose-response analyses revealed that HGI decreased with increasing intakes of Mg when reached the point above 412 mg/day. There was a linear dose-response relationship between dietary Mg intake and HGI in diabetic subjects, and there was an L-shape dose-response relationship in non-diabetic individuals. Increasing the intake of Mg might help lower the risk associated with high HGI. Further prospective studies are requested before dietary recommendations.

Patient-Provider Communication and Adherence to Cholesterol Management Advice: Findings from a Cross-Sectional Survey

High cholesterol is a preventable risk factor for heart disease. This study examines which aspects of patient-provider communication are associated with patient report of increased adherence to cholesterol management advice in a diverse, low-income patient population accessing the health care safety net, using the 2014 Health Center Patient Survey. Patient-provider communication measures included patient report of: how often a provider listened carefully, gave easy-to-understand information, knew important information about the patient's medical history, showed respect, and spent enough time with the patient. Outcome measures were patient report of following provider advice to eat fewer high fat or high cholesterol foods, manage weight, increase physical activity, or take prescribed medicine. In adjusted analyses, when patients perceived their provider always knew their medical history, patients were more likely to report taking prescribed medication (adjusted odds ratio [aOR]: 3.2; 95% confidence interval [CI]: 1.6, 6.6). Knowledge of medical history (aOR: 2.8, 95% CI: 1.4, 5.8), spending enough time (aOR: 2.3, 95% CI: 1.2, 4.4), and providing easily understandable information (aOR: 2.2, 95% CI: 1.0, 4.7) were significantly associated with report of following physical activity advice. Knowledge of medical history (aOR: 2.3, 95% CI: 1.0, 5.2) and providing easily understandable information (aOR: 3.3, 95% CI: 1.4, 7.9) were significantly associated with report of following weight management advice. This study indicates different components of patient-provider communication influence patient adherence to lifestyle modification advice and medication prescription. These results suggest a tailored approach to optimize the impact of patient-provider communication on cholesterol management advice adherence.

Public perceptions, knowledge and awareness of cholesterol management in Singapore: a prospective pilot study

INTRODUCTION

Hyperlipidaemia is a major risk factor for coronary artery disease (CAD). Its effective treatment has been shown to reduce the incidence of cardiovascular events, both in secondary and primary prevention. An essential component of risk factor management at the community level is public awareness and knowledge of treatment benefits. However, this data is limited in Singapore.

METHODS

A cross-sectional survey questionnaire of public perception and knowledge on cholesterol treatment among adult Singaporeans aged 30-69 years was commissioned by the Singapore Heart Foundation and conducted by a professional market survey company. Regional quota sampling was performed to ensure that the sample was representative of the Singapore population. This was followed by random sampling of households and respondents.

RESULTS

Of the 365 respondents, 40.9% were male, 70.3% were Chinese, 18.8% Malay and 10.9% Indian. The mean age was 47.5 years. Although 81.9% of respondents had medical check-ups involving blood tests, only 11.0% knew their actual cholesterol levels. A third of the respondents saw herbal medicine as healthier and safer than Western medication. More than 80% of respondents believed that diet and exercise were equally effective at lowering cholesterol as medication. About half of the respondents associated long-term use of statins with damage to the liver and kidney, while a third associated chronic statin use with the development of cancer.

CONCLUSION

There are gaps in the level of public awareness and understanding of cholesterol treatment in Singapore. Common misconceptions should be addressed, as they could potentially impair effective management or treatment compliance.

Psychometric properties of the Perceived Therapeutic Efficacy Scale for adhering to a cholesterol-lowering diet

BACKGROUND

Outcome expectancy may play an important role in behavior change. Previous studies tested the validity and the reliability of the Perceived Therapeutic Efficacy Scale (PTES), a scale that measures outcome expectancy related to adhering to a cholesterol-lowering diet. Further study was needed to examine its psychometric properties in a larger sample.

OBJECTIVE

The aim of this study was to test the psychometric properties of the 10-item PTES in a large sample.

METHODS

The PTES and the Connor Diet Habit Survey were administered to adults enrolled in a cardiac rehabilitation program.

RESULTS

The final sample for the analysis (N = 224) was, on average, 69.35 years old and was predominantly men (66.50%) and white (92.40%); nearly all (96.00%) completed high school. The inter-item correlation matrix revealed that correlation coefficients were greater than 0.80 between 4 pairs of items, suggesting that the 4 items were redundant. After consulting with a content expert and an examination of item content, we removed the 4 redundant items (items 2, 3, 4, and 10) and reduced the scale to 6 items. Principal component analysis revealed a 1-factor scale with high loadings for the 6 items, each greater than 0.70. The reliability of the scale, measured by Cronbach's α, was 0.91. The total PTES score had a moderate correlation with self-reported behaviors of adhering to a cholesterol-lowering diet, as measured by the Connor Diet Habit Survey subscale for cholesterol and fat intake (r = 0.36, P < 0.05).

CONCLUSIONS

This study demonstrated that the revised and shortened PTES scale is reliable and valid to measure outcome expectancy related to adhering to a cholesterol-lowering diet.

Prevalence, awareness, treatment, and control of dyslipidemia among adults in Beijing, China

AIM

The present study aimed to determine the up-to-date prevalence, awareness, treatment, and control of dyslipidemia, and their distribution and related influencing factors in adults in Beijing, China.

METHOD

A cross-sectional study was conducted in 2008, using a four-stratified cluster sampling. Data from a questionnaire, physical examination, and blood sampling were obtained from 5761 adults aged 18-79 years.

RESULTS

The prevalence of high TC, high LDL-C, low HDL-C and TG was 12.2%, 17.9%, 12.0% and 15.1%, respectively. The prevalence of dyslipidemia was 35.4% (42.9% in men and 30.1% in women), and was similar in rural (35.3%) and urban (35.8%) areas. Dyslipidemia was associated with male gender, age, a family history of dyslipidemia, education at college or above, current smoker, overweight and obesity, intermediate and high waist circumference, hypertension and diabetes. Among all participants with dyslipidemia, 22.2% were aware of the diagnosis, 10.2% were receiving treatment, and 3.8% had dyslipidemia controlled. The proportion of those aware of their condition and those who were treated increased with age in both sexes. Of those aware of their dyslipidemia, 46.1% were on treatment, 51.0% had modified their lifestyle, and 24.5% were not receiving treatment or modifying their lifestyle.

CONCLUSIONS

The major type of dyslipidemia in Beijing is high LDL-C rather than high TG. The prevalence of dyslipidemia is similarly high in rural and urban areas, with low awareness, treatment and control. A comprehensive strategy toward the prevention, screening, treatment, and control of dyslipidemia is needed to slow the epidemic of cardiovascular disease.