HYPERLIPIDEMIA - DIFFERENCES IN MANAGEMENT-PRACTICES AND ATTITUDES IN2 REGIONS IN EUROPE - SICILY AND THE STOCKHOLM AREA

In order to compare attitudes and management concerning hyperlipidaemi a and risk factors for coronary heart disease among doctors in norther n and in southern Europe, a questionnaire study was undertaken among d octors in primary health care and departments of internal medicine in Sicily and Stockholm. The regions differed in culture and health-care structure. Guidelines were similar, but screening of healthy individua ls was recommended in Sicily, and not in Sweden. One hundred and fifty -three general practitioners in Sicily and 120 in Stockholm, 211 inter nists in Sicily and 83 in Stockholm participated. Main outcome measure s were management policies for investigation and treatment and also at titudes. Routine lipid checks at first visits were done by few doctors in Stockholm but by a majority in Sicily (p < 0.001); in the presence of general cardiovascular risk factors (other than heredity, diabetes , cardiovascular disease and hypertension), routine checks were carrie d out more often by both general practitioners (p < 0.001) and interni sts (p < 0.005) in Stockholm. Drug treatment was initiated at lower ch olesterol levels for secondary and primary intervention, cardiovascula r disease, cardiovascular risk factors and hereditary hyperlipidaemia by both groups in Sicily (p < 0.001), as was dietary treatment. Second ary prevention was considered important by all groups, but primary pre vention only by Sicilian doctors. We concluded that there were differe nces in views and management practice between doctors in Sicily and in Stockholm on the investigation and treatment of patients with hyperli pidaemia. Doctors tested lipids at first visits in Sicily but not in S tockholm. Treatment was initiated at lower levels of cholesterol in Si cily.