A Pharmacist's Guide to OTC Therapy: Cholesterol Monitors

DECEMBER 01, 2006
Yvette C. Terrie, BSPharm, RPh

In the United States, approximately 20% of adults have elevated cholesterol levels.1 That means, 1 in every 5 American adults has a cholesterol level of 240 mg/dL or greater.2

Various risk factors may contribute to increase the incidence of elevated cholesterol levels. Examples of these risk factors include:

  • Age and gender
  • Familial history of early cardiovascular disease
  • History of diabetes
  • History of hypertension
  • Diet (high in saturated fats and cholesterol)
  • Being overweight
  • Sedentary lifestyle
  • Smoking

Over-the-counter Cholesterol Tests

As the number of individuals with hypercholesterolemia increases, the use of home cholesterol tests is also on the rise. These testing kits assist many individuals in monitoring cholesterol levels as a means of reducing their risk of developing cardiovascular problems. Pharmacists are in a key position to make patients, especially those with cardiovascular risk factors, aware of the options available for monitoring cholesterol levels at home. While the majority of at-home cholesterol tests measure only total cholesterol (Table 1), a few tests also can measure low-density lipoprotein cholesterol (Table 2), high-density lipoprotein cholesterol (HDL-C) (Table 3), and triglycerides (Table 4).

Patient Counseling

It is important for pharmacists to thoroughly counsel patients about the proper use of these tests. Prior to recommending any of these tests, pharmacists should always determine if the patient has any coagulation disorders or is taking anticoagulants, since the finger stick could put such a patient at risk for excessive bleeding. Therefore, the use of at-home cholesterol tests is not recommended for these patient populations. They should be encouraged to seek the advice of their primary health care provider. Patients also should be advised of certain factors that may interfere with the results of these tests. Examples include avoiding doses of 500 mg or more of vitamin C, as well as avoiding acetaminophen or naproxen within 4 hours of testing, since these factors may interfere with results.1 Individuals also should be encouraged to have follow-up testing with a physician if they have any further concerns, especially if their total cholesterol is 200 mg/dL or greater, their HDL-C is 40 mg/dL or less, or their triglycerides are 150 mg/dL or greater.1

Encouraging patients to be knowledgeable about their cardiovascular risks, as well as informing them of measures that can decrease their risks, are other ways pharmacists can be indispensable in promoting good health. The use of at-home cholesterol monitors (examples listed in Table 5) empowers patients with an easy tool that can be used to routinely monitor cholesterol levels. It is important that pharmacists remind patients to always follow up with their physician for more thorough testing.

Ms. Terrie is a clinical pharmacy writer based in Haymarket, Va.

For a list of references, send a stamped, self-addressed envelope to: References Department, Attn. A. Rybovic, Pharmacy Times, Ascend Media Healthcare, 103 College Road East, Princeton, NJ 08540; or send an e-mail request to: arybovic@ascendmedia.com.