Blood cholesterol treatment attitudes of community physicians: a major problem.

Blood cholesterol treatment attitudes of community physicians are an important component of the NIH recommendation to reduce blood cholesterol. To determine current blood cholesterol treatment attitudes, a survey of 2413 multispecialty Northern California physicians was conducted. A total of 793 physicians responded. Results show that treatment habits among medical specialties are similar with a tendency for lower initial treatment levels in the subspecialties of endocrinology and cardiology. No specialty or subspecialty group indicated an aggressive plasma lipid treatment attitude. The findings include the following: Mean values at which physicians reported treating hypercholesterolemia with medication (312 +/- 44 mg/dl) exceed the NIH definition of "high risk." Younger physicians treated hypercholesterolemia with diet at significantly lower blood cholesterol levels than did older colleagues (p = 0.04). Physicians exposed to the CPPT-LRC investigation did not show a difference in treatment attitudes with regard to blood cholesterol levels when compared to physicians without such an experience. The type of lipid-lowering medication used differs significantly among medical specialties and subspecialties. Physicians lack confidence in the precision of laboratory measurement of plasma lipids. Physician treatment attitudes require substantial change if the NIH cholesterol consensus conference goals are to be achieved.