RESEARCH DONE by Dr Michelle Harris, from the Department of Community Health and Psychiatry, The UWI, Mona, shows that a high proportion of patients attending local primary care clinics have high levels of cholesterol which can lead to the development of heart disease. Harris conducted research at six primary care health centres in the south-east region of Kingston, St Andrew and St Catherine in 2012 and 2013.
“I conducted this research as part of my PhD dissertation in Public Health as I had an interest in cholesterol as a major risk factor in the development of hypertension and cardiovascular disease, which includes stroke and heart attack. In 2012, we did a baseline audit, followed by an intervention in three of the six health centres in 2012 – 2013, then repeated the audit in November 2013,” Harris said.
HARRIS … the presence of high cholesterol puts people at risk of developing heart disease and stroke
She conducted her study among patients who attended the chronic disease clinics for hypertension and diabetes. Her research revealed that patients over 80 years old were more likely to have their cholesterol levels controlled. The study also found that men were more likely to have their cholesterol levels controlled.
“I surmise that the greater prevalence of poor cholesterol control in women is connected to the greater levels of overweight and obesity that is seen in women than in men,” Harris said. “About half of the patients surveyed were prescribed statin – a medication to control cholesterol – but we could not tell if they were taking their medication as prescribed or not,” she added.
Cholesterol is a necessary and important substance for the human body to function efficiently. It is generated in the body and is also contained in animal-based foods. However, Harris said high cholesterol levels are harmful to the body and high cholesterol foods such as those high in saturated fat, for example, chips, French fries, and fried foods, especially those fried in oil that has been used repeatedly, should be avoided. She said people can gain control of their cholesterol levels by changing their diets, eating healthier (eating more fruits and vegetables), increasing physical exercise, and using medication where indicated.
“The presence of high cholesterol puts people at risk of developing heart disease and stroke,” Harris emphasised. In addition, she pointed out that heart disease also includes heart attacks, and that too much cholesterol could result in a build-up of plaque in the walls of the blood vessels, forcing the heart to pump at a greater pressure to get the blood to the tissues. “This leads to enlarging of the heart muscles. Also, the build-up of plaque can cause the blood vessels to become blocked as there is no room for the blood to pass through. Over time, the increased blockage can lead to total blockage in the arteries of the heart, which causes heart attacks,” Harris explained.
“There is a lot that is being done to reduce high blood pressure in the population, but we should also try to address the high cholesterol,” she emphasised. Added Harris: “All of this can be improved with a change of lifestyle to that which includes healthy food choices, increased physical activity, taking medication as prescribed, and no smoking.”
In addition to proper diet, exercise and medication, Harris said people should be “tested and treated to have their cholesterol levels controlled and reduce the risk of developing heart disease”.
According to Harris’ research, less than half (44%) of patients had a lipid (cholesterol) test done within the recommended 12-month period. However, over a three-year period, most (87%) of the patients did at least one test, and that test measured four lipid components – the total cholesterol, the LDL or “bad” cholesterol, the HDL or “good” cholesterol and the triglycerides. The tests also showed that 90% of the patients had at least one abnormal cholesterol value.