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State of Alaska

Health Indicator Report of Blood Cholesterol: Doctor-diagnosed High Blood Cholesterol - Adults (M 35+/F 45+)

High cholesterol is a major and modifiable risk factor for heart disease and stroke.^2^ High cholesterol is usually defined as total blood cholesterol above 240 mg/dL. Of an estimated 73.5 million U.S. adults who have high cholesterol, only 48.1% of them receive treatment and less than a third manage their condition.^3^ There are no symptoms of high blood cholesterol. Therefore, it is recommended that everyone age 20 and older have their cholesterol measured at least once every 5 years.^4^ Elevated levels of cholesterol can lead to development of atherosclerosis (hardening and narrowing of the arteries).^5^ Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. High cholesterol has been associated with physical inactivity, smoking cigarettes, high fat intake, diabetes, and obesity. The risks associated with high blood cholesterol can be reduced by screening and early treatment. All risk factors for high cholesterol cannot be controlled; however, lifestyle changes and medication can lead to reduced cholesterol levels and prevent heart disease.^6^[[br]][[br]] ---- {{class .SmallerFont 2. High blood cholesterol levels: MedlinePlus Medical Encyclopedia. [https://medlineplus.gov/ency/article/000403.htm] Accessed March 8, 2017. 3. Centers for Disease Control and Prevention. High cholesterol facts. [http://www.cdc.gov/cholesterol/facts.htm]. Updated March 17, 2015. Accessed March 8 2017. 4. Cholesterol testing and results: MedlinePlus Medical Encyclopedia. [https://medlineplus.gov/ency/patientinstructions/000386.htm]. Accessed March 8, 2017. 5. National Health and Nutrition Examination Survey; National Heart, Lung, and Blood Institute, National Cholesterol Education Program (2002). Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143-3421. 6. Dietary Guidelines to Treat and Prevent Atherosclerosis | The Physicians Committee for Responsible Medicine. [http://www.pcrm.org/health/heart/treat-and-prevent-atherosclerosis]. Accessed March 13, 2017. }}

Notes

The question on doctor-diagnosed high blood cholesterol has been asked in odd-number years since 1991, with the addition of 1992. Be aware of the single year comparisons around 1992. U.S. values are based upon the median value of the states, District of Columbia, and territories.

Data Sources

  • Alaska Data: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System], Alaska Department of Health and Social Services, DPH, Section of Chronic Disease Prevention and Health Promotion
  • U.S. Data: National Center for Chronic Disease Prevention and Health Promotion, Behavioral Risk Factor Surveillance System (BRFSS)

Data Interpretation Issues

The cholesterol questions are included in the BRFSS on odd numbered years since 1991, with the exception of also being asked in 1992 and 2006. The doctor diagnosed high blood cholesterol question is only asked of respondents who reported ever having their blood cholesterol checked. This means that the actual prevalence of high cholesterol is probably higher than the numbers reported here. Data for this indicator report are from the Behavioral Risk Factor Surveillance System (BRFSS), a telephone survey of adults 18 and over. The survey is conducted in all 50 states, D.C., and U.S. territories. Data from the Alaska Behavioral Risk Factor Survey are intended to represent non-institutionalized adults in households with telephones. Information on background and methodology of the BRFSS managed by the Centers for Disease Control and Prevention (CDC) can be found at: [http://www.cdc.gov/brfss/]. The website for the Alaska BRFSS is: [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx]. Due to changes in sampling and weighting methodology, 2011 is a new baseline for BRFSS, and comparisons with prior year data are inappropriate. ^1^[[br]][[br]] ---- {{class .SmallerFont 1. Centers for Disease Control and Prevention. Indicator Definitions - Cardiovascular Disease. [https://www.cdc.gov/cdi/definitions/cardiovascular-disease.html#CVD4_0]. Published 2015. Accessed December 28, 2016. }}

Definition

Percentage of adults (males 35 years of age and older and females 45 years of age and older) who responded "yes" on the [http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspx Behavioral Risk Factor Surveillance System (BRFSS)] to the question "Have you EVER been told by a doctor, nurse or other health professional that your blood cholesterol is high?"

Numerator

Weighted number of adults (M 35+/F 45+) who responded "yes" on the BRFSS to the question "Have you EVER been told by a doctor, nurse or other health professional that your blood cholesterol is high?"

Denominator

Weighted number of adults (M 35+/F 45+) who responded "yes" to ever having their blood cholesterol checked. [http://ibis.dhss.alaska.gov/indicator/view/BloCholScr.AK_USYear.html].

Healthy People Objective: Reduce the proportion of adults with high total blood cholesterol levels

U.S. Target: 13.5 percent

Other Objectives

Healthy People 2020 Heart Disease and Stroke: HDS-6 Increase the proportion of adults who have had their blood cholesterol checked within the preceding 5 years HDS-7 Reduce the proportion of adults with high total blood cholesterol levels HDS-8 Reduce the mean total blood cholesterol levels among adults HDS-13 (Developmental) Increase the proportion of adults with elevated LDL cholesterol who have been advised by a health care provider regarding cholesterol-lowering management, including lifestyle changes and, if indicated, medication (advised regarding cholesterol-lowering ... diet, physical activity, weight control, and drug therapy) HDS-14 (Developmental) Increase the proportion of adults with elevated LDL cholesterol who adhere to the prescribed LDL-cholesterol lowering management lifestyle changes and, if indicated, medication (adhere to prescribed cholesterol-lowering ... diet, physical activity, weight control, and drug therapy) HDS-20 Increase the proportion of adults with coronary heart disease or stroke who have their low-density lipoprotein (LDL) cholesterol level at or below recommended levels

How Are We Doing?

In 2017, 42.1% of Alaska adults (M 35+/F 45+) have been told they have high blood cholesterol by a health professional. Prevalence of high blood cholesterol has been relatively stable in Alaska over the past decade. The prevalence of high blood cholesterol increased significantly with age and weight status.

How Do We Compare With the U.S.?

The percentage of Alaskans who have been diagnosed with high cholesterol has been above that seen in the U.S. since 1995. In 2015, 43.7% of Alaskan adults had high blood cholesterol compared to 36.4% in the U.S.

What Is Being Done?

Alaska's [http://dhss.alaska.gov/dph/Chronic/Pages/Cardiovascular/default.aspx Heart Disease and Stroke Prevention Program (HDSP)] provides staffing and support for the statewide coalition, [http://dhss.alaska.gov/sites/takeheart/Pages/main.aspx Take Heart Alaska]. Take Heart Alaska is a partnership of agencies, organizations, and individuals working to promote cardiovascular health, prevent cardiovascular disease and improve cardiovascular care. Additional information on current cardiovascular disease prevention efforts in Alaska is available at: [http://dhss.alaska.gov/dph/Chronic/Pages/Cardiovascular/default.aspx] or [http://dhss.alaska.gov/sites/takeheart/pages/main.aspx].

Evidence-based Practices

It is best to have a blood test called a "lipoprotein profile" to find out cholesterol numbers.^4^ This blood test is done after a 9- to 12-hour fast. Aggressive treatment focuses on lowering LDL ("bad" cholesterol levels). LDL cholesterol is considered first and is the primary target of therapy if high. Lowering LDL cholesterol reduces the risk of coronary heart disease and ischemic stroke. Low cholesterol diet, increased exercise, and statin medications are the first line of treatment. Select Community Preventive Services Task Force (Community Guide) recommendations: [http://www.thecommunityguide.org/cvd/CDSS.html Clinical Decision-Support Systems (CDSS)] CDSS are computer-based information systems designed to assist healthcare providers in implementing clinical guidelines at the point of care. CDSS use patient data to provide tailored patient assessments and evidence-based treatment recommendations for healthcare providers to consider. Patient information is entered manually or automatically through an electronic health record (EHR) system. [http://www.thecommunityguide.org/cvd/CHW.html Interventions Engaging Community Health Workers] Community health workers--including promotores de salud, community health representatives, community health advisors, and others--are frontline public health workers who serve as a bridge between communities and healthcare systems. They are from, or have an unusually close understanding of, the community served. Community health workers are trained to provide culturally appropriate health education and information, offer social support and informal counseling, connect people with the services they need, and in some cases deliver health services such as blood pressure screening. Because community health workers are considered informed and trusted community members, they are uniquely positioned to advocate on behalf of individuals and communities and help build capacity. Community health workers often receive on-the-job training and work without professional titles. Organizations may hire paid community health workers or recruit volunteers to act in this role. [http://www.thecommunityguide.org/cvd/ROPC.html Reducing Out-of-Pocket Costs for Cardiovascular Disease Preventive Services for Patients with High Blood Pressure and High Cholesterol] Reducing out-of-pocket costs (ROPC) for patients with high blood pressure and high cholesterol involves program and policy changes that make cardiovascular disease preventive services more affordable. These services include: * Medications * Behavioral counseling (e.g., nutrition counseling) * Behavioral support (e.g., community-based weight management programs, gym membership) Costs for these services can be reduced by providing new or expanded treatment coverage and lowering or eliminating patient out-of-pocket expenses (e.g., copayments, coinsurances, deductibles). [[br]][[br]] ---- {{class .SmallerFont 4. Cholesterol testing and results: MedlinePlus Medical Encyclopedia. [https://medlineplus.gov/ency/patientinstructions/000386.htm]. Accessed March 8, 2017. }}

Available Services

'''Services Available to the Public:''' The Million Hearts initiative is a national effort to prevent 1 million heart attacks and strokes by 2017. Million Hearts is an innovative alignment and coordination of clinical and community activities targeting leading causes of cardiovascular disease morbidity and mortality, including high blood cholesterol. These and other community and clinical activities are important measures to combat the impact of high blood cholesterol nationally. [http://www.millionhearts.hhs.gov./ ] The American Heart Association offers tools and resources for managing cholesterol for patients and providers. [http://www.heart.org/] The National Diabetes Education Program (NDEP) has instituted the ABC campaign which promotes the screening for A1C (blood glucose or sugar), Blood Pressure, and Cholesterol as monitoring measures to help control diabetes and heart disease. [https://www.niddk.nih.gov/health-information/health-communication-programs/Pages/default.aspx] '''More Information and Resources:''' AHA Heart-Health Screenings [http://www.heart.org/HEARTORG/Conditions/Heart-Health-Screenings_UCM_428687_Article.jsp#.WF2Qyv7FCmw] The Guide to Community Preventive Services [http://www.thecommunityguide.org/index.html] WISEWOMAN [https://www.cdc.gov/wisewoman/] StateHealthFacts.org [http://www.statehealthfacts.org/]

Health Program Information

In December 1998, the Alaska Division of Public Health developed a comprehensive plan to reduce heart disease and stroke (cardiovascular disease) in Alaska. The Take Heart Alaska Cardiovascular Disease Prevention Plan was developed in collaboration with the American Heart Association, Alaska Health Fair, and representatives from hospitals, tribal organizations, and governmental offices, and with help from experts in cardiology, wellness, nutrition, and physical activity. Starting in October 2001, the Centers for Disease Control and Prevention began providing the State of Alaska with a grant to address cardiovascular health in the state.
Page Content Updated On 09/21/2018, Published on 11/02/2018
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health (Ak-IBIS) web site (http://ibis.dhss.alaska.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 20 November 2018 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Alaska Indicator-Based Information System for Public Health web site: http://ibis.dhss.alaska.gov ".

Content updated: Thu, 8 Nov 2018 09:38:04 AKST
The information provided above is from the Alaska Department of Health and Social Services' Center for Health Data and Statistics AK-IBIS web site (http://ibis.dhss.alaska.gov/). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Tue, 20 November 2018 17:04:16 from Alaska Department of Health and Social Services, Center for Health Data and Statistics, Indicator-Based Information System for Public Health Web site: http://ibis.dhss.alaska.gov/ ".

Content updated: Thu, 8 Nov 2018 09:38:04 AKST