A Guideline-Driven Assessment of Need for Cardiovascular Disease Risk Intervention in Persons With Chronic Paraplegia

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Abstract

Nash MS, Mendez AJ. A guideline-driven assessment of need for cardiovascular disease risk intervention in persons with chronic paraplegia. Objective: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. Design: Cross-sectional. Setting: Academic medical center. Participants: Forty-one subjects (mean age ± standard deviation, 34±11y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. Interventions: Not applicable. Main Outcome Measures: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. Results: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (χ12 test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. Conclusions: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.

Original languageEnglish
Pages (from-to)751-757
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume88
Issue number6
DOIs
StatePublished - Jun 1 2007

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Needs Assessment
Paraplegia
Cardiovascular Diseases
Guidelines
Life Style
Therapeutics
Lipids
HDL Cholesterol
Cholesterol
Outcome Assessment (Health Care)
Hypertension
Education

Keywords

  • Cardiovascular diseases
  • Lipids
  • Paraplegia
  • Rehabilitation
  • Risk

ASJC Scopus subject areas

  • Rehabilitation

Cite this

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title = "A Guideline-Driven Assessment of Need for Cardiovascular Disease Risk Intervention in Persons With Chronic Paraplegia",
abstract = "Nash MS, Mendez AJ. A guideline-driven assessment of need for cardiovascular disease risk intervention in persons with chronic paraplegia. Objective: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. Design: Cross-sectional. Setting: Academic medical center. Participants: Forty-one subjects (mean age ± standard deviation, 34±11y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. Interventions: Not applicable. Main Outcome Measures: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. Results: A total of 34.1{\%} of subjects qualified for intervention based on the ATP II Guidelines and 63.4{\%} based on ATP III (χ12 test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1{\%} satisfied criteria for diagnosis of the metabolic syndrome. Conclusions: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.",
keywords = "Cardiovascular diseases, Lipids, Paraplegia, Rehabilitation, Risk",
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N2 - Nash MS, Mendez AJ. A guideline-driven assessment of need for cardiovascular disease risk intervention in persons with chronic paraplegia. Objective: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. Design: Cross-sectional. Setting: Academic medical center. Participants: Forty-one subjects (mean age ± standard deviation, 34±11y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. Interventions: Not applicable. Main Outcome Measures: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. Results: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (χ12 test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. Conclusions: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.

AB - Nash MS, Mendez AJ. A guideline-driven assessment of need for cardiovascular disease risk intervention in persons with chronic paraplegia. Objective: To examine percentages of persons with chronic paraplegia who qualify for lipid-lowering therapeutic lifestyle intervention (TLI) as assessed by authoritative guidelines. Design: Cross-sectional. Setting: Academic medical center. Participants: Forty-one subjects (mean age ± standard deviation, 34±11y) with motor-complete paraplegia (American Spinal Injury Association grade A or B) at T6-L1 levels for greater than 2 years. Interventions: Not applicable. Main Outcome Measures: Percentages of subjects qualifying for TLI were independently assessed and then compared using National Cholesterol Education Project Adult Treatment Panel (ATP) II (1994) and ATP III (2002) Guidelines. Results: A total of 34.1% of subjects qualified for intervention based on the ATP II Guidelines and 63.4% based on ATP III (χ12 test=4.53; 2-tailed, P=.003). Seventy-six percent (31/41) of study participants had high-density lipoprotein cholesterol levels below the high-risk criterion of 40mg/dL established by ATP III. Almost one third of subjects had hypertension, and 34.1% satisfied criteria for diagnosis of the metabolic syndrome. Conclusions: A high percentage of young, apparently healthy people with chronic paraplegia are at risk for cardiovascular disease and qualify for lipid-lowering TLI. Updated guidelines of the ATP III have increased the urgency for early risk assessment and intervention.

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