Detection and measurement of hypercholesterolaemia in South Africans attending general practitioners in private practice - The cholesterol monitor

Background. This paper reports data on the detection and management of hype rcholesterolaemia in patients attending general practitioners in private pr actice in South Africa. Methods. The frequency of cholesterol testing and the level at which active therapeutic intervention occurred at medical practices were monitored over a 2-year period. A sample of 200 medical practitioners was selected from p rivate practices in major cities. Data on patients seen by the selected doc tors during a May monitoring period were recorded on a standardised form. Results. 12 842 patients were seen by the 200 private practice GPs. More me n (18.7%) than women (10.4%) had coronary heart disease (CHD), and their me an total cholesterol (TC) levels were 5.9 mmol/l and 6.0 mmol/l, respective ly. Only 3.1% of the patients were reported to have familial hypercholester olaemia (FH) and 12.8% were reported to have a family history of CHD. Repor ted smoking rates were exceptionally high (77.5% of women and 64.4% of men) . The most commonly prescribed group of lipid-lowering agents was HMG-CoA r eductase inhibitors. Conclusions. Inadequate management of hypercholesterolaemia leaves many pat ients with a high risk of CHD mortality in South Africa. Appropriately inve stigated patients with hypercholesterolaemia should receive treatment to re duce cardiovascular disease using more effective TC control programmes than are currently used in South Africa.