Abstract P337: Identifying Abnormal Cholesterol in Underserved Urban Communities through Health Fairs
Introduction: Cholesterol screening at health fairs in underserved urban communities is becoming common, though little evidence guides these efforts. We sought to describe the proportion of patients identified with elevated low-density lipoprotein cholesterol (LDL) and reduced high-density lipoprotein cholesterol (HDL) at such fairs and the changes in LDL and HDL over time for returning patients. We hypothesized that patients would reduce their LDL in association with weight loss.
Methods: DOCS is a medical student run service organization providing free screening services, health education, and when indicated referrals to low cost clinics. We reviewed the records of new patients receiving cholesterol screening at an annual DOCS fair in an underserved urban community in South Florida (Little Haiti, Hialeah, and Pompano Beach) in 2007 and any future visits.
Results: In 2007, 223 new patients received cholesterol screening, of whom 111 (50%) were 45 to 64 yrs old, 136 (61%) Hispanic, 50 (22%) Haitian, and 142 (80%) uninsured. Of the 221 new patients, 102 (46%) had an LDL above 129 mg/dL (59 from 130-159, 30 from 160−189, and 13 >189) and 82 (37%) had an HDL below 40 mg/dL for males or 50 for females. An LDL above 129 mg/dL was common across all ages, sexes, and BMIs (Figure) and not associated with age (Spearman’s rho=.08, P=.22), BMI (rho=.08, P=.27), or sex (P=.38). Among patients with an LDL above 129 mg/dL, 14 (14%) returned for a screening in 2008 or 2009 and 9 (64%) reduced their LDL by at least 20 mg/dL (6 by >30) though only 2 (14%) increased HDL by at least 5 mg/dL. LDL and BMI reductions were not associated (rho = .10, P=.77).
Conclusions: Cholesterol screening at fairs in underserved urban communities identified patients with elevated LDL and reduced HDL across all ages, sexes, and BMIs. While few patients returned to a subsequent fair, most who did lowered their LDL substantially without a change in BMI or HDL. This may suggest that referrals to low cost clinics and pharmacotherapy play an important role in the potential of fairs to reduce LDL.
Funding(This research has received full or partial funding support from the American Heart Association, Greater Southeast Affiliate (Alabama, Florida, Georgia, Louisiana, Mississippi, Puerto Rico&Tennessee)
- © 2012 by American Heart Association, Inc.