An NIH study examined doctors' attitudes and practices toward managing high cholesterol in patients who had had a heart attack. They found that younger doctors were more likely to start dietary and drug therapy in these patients at lower total and LDL cholesterol levels than their older counterparts. The doctors also started drug therapy in younger patients at lower levels than in older patients.

The researchers, who surveyed family practice doctors (GPs), cardiologists and internists in a Massachusetts community, made these other discoveries:

• GPs initiated dietary therapy at lower total cholesterol levels than the other doctors.
• GPs prescribed lipid-lowering drugs at higher total and LDL cholesterol levels than the others.
• Younger doctors consider LDL levels the most important factor when starting drug therapy; older physicians relied on total cholesterol measurements.

The doctors reported that the most important factors that interfere with their patients' use of lipid-lowering medications were concerns about their cost, worry about taking too many drugs, and failure to appreciate the importance of lipid-lowering drugs.

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Source:  Yarzabski J, Bujor CF, Goldberg RJ, et al. A community-wide survey of physician practices and attitudes toward cholesterol management in patients with recent acute myocardial infarction. Archives of Internal Medicine. April 8, 2002;162:797-804. (Abs.)