Disparity between whites and african-americans in knowledge and treatment of cholesterol: Carolina heart survey

PURPOSE: Elevated cholesterol is a known risk factor for coronary heart disease and studies have demonstrated a decrease in myocardial infarctions and strokes in those treated with cholesterol-lowering medications. A statewide survey was conducted to determine knowledge and treatment of cholesterol in South Carolina residents. METHODS: In 1998, a random digit telephone survey was conducted of 1200 adults in South Carolina, including 28.2% African Americans (AA), using a 46-item instrument developed to quantify awareness, knowledge and treatment of cholesterol. RESULTS: Nearly 90% of both AA and Whites (W) believe high cholesterol levels can cause a “heart attack.” However, more AA (90.2%) than W (82.8%) believe that high cholesterol levels cause a “stroke” (p = 0.005). Though not statistically significant, 19.5% of W compared to 23.4% of AA reported not ever having their cholesterol checked (p = 0.066). Of those who had their cholesterol checked, less than half (47%) knew their most recent cholesterol or knew a “good” cholesterol level for an adult (41%). Fewer AA could recall their cholesterol level (p = 0.011), or knew a “good” cholesterol level for an adult (p < 0.001) as compared with W. Of the 24.2% who were told they had elevated cholesterol, 59% were under the care of a physician for cholesterol treatment, of which 56.6% reported taking cholesterol-lowering medications. There was a significant difference in the reported treatment with cholesterol-lowering medications between W and AA, 63% versus 33%, respectively (p = 0.006) and ranged from a high of 73.5% in W males to 29.4% in AA females (p = 0.005). CONCLUSIONS: The results of this population assessment suggest less knowledge about cholesterol among AA and racial disparity with regard to treatment with medications of elevated cholesterol levels.