Hyperlipidaemia screening among patients with both diabetes mellitus and hypertension-experience at a public health centre

ABSTRACT

OBJECTIVE: To assess the frequency of screening for hyperlipidaemia among patients with both diabetes mellitus and hypertension who attended a public health centre in Jamaica between June 1997 and December 2000. METHODS: This study was conducted among all patients with both diabetes mellitus and hypertension who attended the Hermitage August Town Health centre between June 1997 and December 2000. Subjects were identified from the clinic daily register using the International Classification of Disease (ICD-9) codes for hypertension (ICD-401) and diabetes mellitus (ICD-250). Patients' dockets were reviewed to identify those who had any test for hyperlipidaemia during this period. Results of these tests were noted. Abnormal blood lipid results (in mmol/l) were assessed as total cholestorol> 6.50; low density lipoprotein> 3.60; triglycerides> 2.37; high density lipoprotein< 1.17. RESULTS: For the period of the study, 127 persons with both diabetes mellitus and hypertension were seen at the clinic (78 percent females and 22 percent males) ranging in age from 37 to 91 years with a median age of 61 years. Only 17 (13.4 percent) patients had a screening test for cholesterol over the study period. Six patients were screened only for cholesterol and 11 screened for both cholesterol and triglycerides. Screening frequency was slightly among persons older than 60 years compared to those less than 60 years (14.2 percent vs 12 percemnt; p> 0.05). Men were more likely to be screened than women (17 percent vs 12 percent; p> 0.05). Of the 17 patients screened, 46 percent had hypercholesterolaemia (total cholesterol> 6.5 mmol/l). CONCLUSIONS: Screening frequency for abnormal lipid profiles was extremely low in this sample of patients. The results of this study, though not generizable to all health centres, highlight what may be a major public health deficit in the control of atherosclerotic-related chronic non-communicable disease in Jamaica. (AU)