J Natl Med Assoc. 2001 Mar; 93(3): 87-91.

Coronary care physician 1994-2000 adherence to 1993 National Cholesterol Education Program diet and lipid recommendations.

Banks T, Ali N.

D.C. General Hospital, 1900 Massachusetts Ave. SE, Washington, DC 20003, USA.

The 1993 NCEP recommended phase 2 diets and < or = 100 mg/dL LDL goals for all atherosclerotic patients. We reviewed Washington, DC physician 1994-2000 use of these recommendations for coronary care unit (CCU) patients. Questionnaires, chart reviews and interviews of cardiologists, residents and dietitians showed > 80% of CCU physicians ignored NCEP dietary recommendations. NCEP 1 diets were ordered for approximately 80% of patients. NCEP 2, AHA 3 or vegetarian diets were used for < 20%. Statins were reported for approximately 25% of patients in 1994-95 but were on < 20% of charts in 1996-7. This increased to approximately 58% by 2000. NCEP 2 diets lower cholesterol approximately 5%, rarely reaching LDL goals, and < 20% of CHD patients on anti-lipid therapy were at NCEP LDL goals by 1999. With 1-year post-myocardial infarction 34% mortality and 53% readmission rates, we need early and much more aggressive anti-lipid diets and drugs in treating these patients.