Prevalence of adequate and of optimal control of serum low-density lipoprotein cholesterol in an academic nursing home.

OBJECTIVE: To determine the prevalence of adequate control of serum low-density lipoprotein (LDL) cholesterol in older persons who were not terminally ill in an academic nursing home.

DESIGN: An increased LDL cholesterol was 100 mg/dL or higher in very high-risk persons with coronary artery disease (CAD), ischemic stroke, peripheral arterial disease, diabetes mellitus, or 2+ risk factors and a 10-year risk for CAD greater than 20%; 130 mg/dL or higher in moderately high-risk persons with 2+ risk factors and a 10-year risk for CAD of 10% to 20%; and 160 mg/dL or higher in low risk persons with 0 to 1 risk factor.

SETTING: An academic nursing home.

PARTICIPANTS: Two hundred and two persons (104 women and 98 men), mean age 73 years (range 50 to 98 years) residing in an academic nursing home.

MEASUREMENTS: Prevalence of use of lipid-lowering drugs and of serum LDL cholesterol less than 100 mg/dL and less than 70 mg/dL in very high-risk persons and less than 130 mg/dL and less than 100 mg/dL in moderately high-risk persons.

RESULTS: Measurements of serum LDL cholesterol were obtained in 135 of 135 very high-risk persons (100%), in 57 of 61 moderately high-risk persons (93%), and in none of 6 low-risk persons (0%). Statins were used in 115 of 135 very high-risk persons (85%) and in 24 of 57 moderately high-risk persons (42%). Ezetimide was used to treat 3 of 135 very high-risk persons (2%). The last serum LDL cholesterol reported was less than 100 mg/dL in 119 of 135 very high-risk persons (93%), less than 70 mg/dL in 108 of 135 very high-risk persons (80%), less than 130 mg/dL in 40 of 57 moderately high-risk persons (70%), and less than 100 mg/dL in 35 of 57 moderately high-risk persons (61%).

CONCLUSION: Serum LDL cholesterol was measured in 192 of 202 older persons (95%) in an academic nursing home. Serum LDL cholesterol was adequately controlled in 93% of very high-risk persons and in 70% of moderately high-risk persons. Serum LDL cholesterol was optimally controlled in 80% of very high-risk persons and in 61% of moderately high-risk persons.