/publications/issue/2003/2003-09/2003-09-7404

Research Identifies Best Criterion for Cholesterol Test

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    Because testing everyone for high levels of blood cholesterol is expensive, a blood test at age 50 may be the most cost-effective method of 4 methods tested to identify those most likely to have a heart attack or stroke in the future. This study result was published recently in the British Medical Journal.

    In a purely hypothetical study, the researchers screened 6307 people aged 30 to 74 with no history of heart attack, stroke, or angina. They used 4 different criteria, to see which of the criteria worked best. The researchers also applied the criteria of the Framingham 10-year coronary heart disease risk equation.

    First, using the guidelines of the British National Health Services, the researchers selected 43.4% needing the cholesterol test; then they identified 81.2% of those as meeting the Framingham criteria for a 15% greater likelihood of a coronary episode in 10 years.

    A second screen, using the Sheffield table?a British set of rules?selected 73.1% of the group as needing the test; the researchers then identified better than 99% of those as meeting the Framingham criteria.

    Using fixed values of blood cholesterol, the screening required tests for only 17.8% of the group, with 75.9% of them meeting the Framingham criteria.

    The ?winning? test used age 50 as the criterion. This screening found that tests were needed for 46.3% of the group, with 92.8% of them identified as high-risk people. Although not as good as the Sheffield criterion, the age-50 screen is less expensive because fewer tests are needed.