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December 2004, Vol 94, No. 12 | American Journal of Public Health 2112-2117
© 2004 American Public Health Association

RESEARCH AND PRACTICE

Is Lipid-Lowering Therapy Underused by African Americans at High Risk of Coronary Heart Disease Within the VA Health Care System?

LeChauncy D. Woodard, MD, MPH, Nancy R. Kressin, PhD and Laura A. Petersen, MD, MPH

LeChauncy D. Woodard and Laura A. Petersen are with the Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey Veterans Affairs Medical Center, and Section for Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, Tex. Nancy R. Kressin is with the Center for Health Quality, Outcomes and Economic Research, Bedford Veterans Affairs Medical Center, Bedford, Mass, and the Health Services Department, Boston University School of Public Health, Boston, Mass.

Correspondence: Requests for reprints should be sent to LeChauncy D. Woodard, MD, MPH, Health Services Research and Development (152), Houston Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX 77030 (e-mail: lwoodard{at}bcm.tmc.edu).

Objectives. We examined whether racial differences exist in cholesterol monitoring, use of lipid-lowering agents, and achievement of guideline-recommended low-density lipoprotein (LDL) levels for secondary prevention of coronary heart disease.

Methods. We reviewed charts for 1045 African American and White patients with coronary heart disease at 5 Veterans Affairs (VA) hospitals.

Results. Lipid levels were obtained in 67.0% of patients. Whites and African Americans had similar screening rates and mean lipid levels. Among the 544 ideal candidates for therapy, rates of treatment and achievement of target LDL levels were similar.

Conclusions. We found no disparities in cholesterol management. This absence of disparities may be the result of VA quality improvement initiatives or prescription coverage through the VA health care system.




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