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Original Articles

Knowledge of Heart Disease Risk Among SHIELD Respondents With Dyslipidemia

Sandra J. Lewis, MD; Kathleen M. Fox, PhD; Michael F. Bullano, PharmD; Susan Grandy, PhD for the SHIELD Study Group

From the Northwest Cardiovascular Institute (S.J.L.), Portland, Ore; Strategic Healthcare Solutions LLC (K.M.F.), Monkton, Md; and AstraZeneca LP (M.F.B., S.G.), Wilmington, Del.

Correspondence to Kathleen M. Fox, PhD, PO Box 543, Monkton, MD 21111. E-mail kathyfox{at}comcast.net

Received November 20, 2008; accepted February 12, 2009.

Background— Respondents in the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) reported whether they had a diagnosis of dyslipidemia, were taking prescription dyslipidemia medication, and knew their heart disease risk (low, moderate, high, or do not know). We assessed whether respondents who reported a diagnosis of dyslipidemia with or without lipid-modifying treatment knew their heart disease risk and whether it correlated with National Cholesterol Education Program Adult Treatment Panel (ATP) III risk.

Methods and Results— Based on self-report of risk factors, ATP III high risk was defined as diagnosis of heart disease/heart attack, narrow/blocked arteries, stroke, or diabetes; moderate risk included 2 risk factors (ie, men aged >45 years, women aged >55 years, hypertension, low high-density lipoprotein cholesterol, current smoking, and family history of CHD); and low risk included <2 risk factors. Of 7629 respondents with dyslipidemia, 35% reported not taking cholesterol medication, and 29% reported not knowing their heart disease risk. For respondents treated for dyslipidemia, 27% reported not knowing their risk, and of the 73% who reported knowing, 24% to 35% reported the same risk level as ATP III risk. For respondents with untreated dyslipidemia, 33% reported not knowing their risk, and of the 67% who reported knowing, 20% to 37% reported the same risk as ATP III risk.

Conclusions— A large proportion of respondents with dyslipidemia did not know their heart disease risk. Among those who reported knowing their risk level, >60% of respondents did not classify themselves at the same ATP III-defined risk level. There is a gap in understanding and awareness of heart disease risk among respondents with dyslipidemia regardless of treatment status.

Key Words: cardiovascular diseases • dyslipidemias • heart diseases