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Physician Monitoring & LDL-C Follow-Up Testing

Prev Med; 2019 Apr; Dansinger, Williams, et al

Within a large patient population, total cholesterol, triglyceride, and low-density lipoprotein cholesterol (LDL-C) concentrations decreased progressively with increased physician monitoring, a new study found. Differences between baselines and follow-up visits were calculated for 97,548 men and 110,424 women whose physicians sent blood to Boston Heart Diagnostics for analysis between 2010‒2017. Researchers found:

  • After adjustment for age and follow-up duration, plasma concentration changes per each follow-up measurement in men and women, respectively, were ‒2.84±0.10 mg/dL and ‒3.03±0.10 mg/dL for total cholesterol, ‒3.78±0.30 mg/dL and ‒2.26±0.19 mg/dL for triglycerides, and ‒2.54±0.09 mg/dL and ‒3.06±0.09 mg/dL for LDL-C.
  • Relative to baseline, significant decreases were observed for the first, second, and third follow-up measurements for total cholesterol, triglycerides, and LDL-C.
  • 6.9%, 9,9%, and 11.8% of men and 5.7%, 9.7%, and 11.5% of women went from having an LDL-C cholesterol ≥160 to <160 mg/dL for their first, second, and third follow-up measurements, respectively.

Citation:

Dansinger ML, Williams PT, Superko HR, Schaefer EJ. The importance of cholesterol follow-up treatment under current statin treatment guidelines. Prev Med. 2019;121:150-157. doi:10.1016/j.ypmed.2019.02.003.

Commentary:

Is it important for a physician to measure cholesterol levels on an annual basis? It has been suggested that ongoing monitoring of cholesterol may not be necessary especially for patients already on lipid lowering therapy. The current study by Dansinger et al. suggests that ongoing monitoring of cholesterol levels leads to lower cholesterol values over time. Significant decreases in cholesterol values were noted after the first, second, and third follow-up measurements. This suggests that both physicians and patients are more likely to take preventive measures if cholesterol values are known and followed over time. Periodic cholesterol measurement seems a prudent part of a good cardiovascular prevention program. —Matthew Sorrentino, MD