Saving Dollars--and Lives
About 1.5 million Americans suffer heart attacks each year, of whom more than one in three dies. Medical experts consider many of these deaths to be premature, the result of a failure to reduce or avoid certain clear risks. Among these are untreated high blood pressure, smoking and a high level of cholesterol in the blood. It is on this last risk that a new report by a federal advisory panel focuses. It urges more intensive efforts by physicians to identify and treat the more than 40 million Americans who are believed to have dangerously high levels of blood cholesterol. A successful campaign to do just that might help save hundreds of thousands of lives a year.
The panel proposes regular testing of cholesterol levels in all Americans beginning at age 20. A cholesterol level of fewer than 200 milligrams per deciliter of blood is considered desirable. Between 200 and 239 is regarded as borderline high, while anything above 240 is seen as posing a high risk. Dietary change is recommended as the first line of attack where risk exists. Very often restricting consumption of total fats, with particular emphasis on saturated fats and cholesterol-rich foods, can reduce serum cholesterol to a desirable level. If dietary changes alone don’t bring about wanted results, treatment with drugs is available.
A more aggressive approach to identifying and treating cholesterol risks reflects in part changing perceptions of where the danger to health begins. It has long been clear that those with cholesterol levels above 200 milligrams run a sharply higher chance of developing coronary heart disease. When other risk factors are present, of which smoking seems the most serious, the potential for heart disease soars. The federal panel reports that a recent survey showed that only 50% of doctors prescribe modified diets for patients with cholesterol readings of 240 or above. That, says Dr. James I. Cleeman, coordinator of the federal National Cholesterol Education Program, leaves untreated almost half the people with high blood cholesterol.
Heart disease costs the nation tens of billions of dollars a year in direct medical expenses and losses in productive work even as it prematurely snuffs out hundreds of thousands of lives. The federal panel says that a lot can be done about this. If doctors heed the panel’s recommendations, and if people do more for their own health, the fearful toll from heart disease almost surely can be cut.
