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1. Risk factors for coronary heart disease include age, sex, family history, high cholesterol, blood pressure, smoking, and severe obesity. The last four risk factors can be modified with lifestyle changes. 2. Occupational health nurses who provide primary care to workers can assist employees in detecting and treating their elevated cholesterol. Cholesterol screening at the workplace is an effective means for employees to learn their cholesterol level or monitor their dietary progress in lowering their cholesterol. 3. Employees can modify their eating behaviors by developing the skills to make wise dietary choices. Simple dietary self assessment and self monitoring tools will aid employees in monitoring and evaluating their efforts. 4. To successfully implement a cholesterol education program and counsel employees, occupational health nurses need to increase their knowledge of nutrition, specifically the composition of a diet that will help reduce the risks associated with heart disease.

1. Most individuals with moderately elevated blood cholesterol can lower their cholesterol significantly by following a low fat, low cholesterol diet, which is the first step in the treatment of hypercholesterolemia. 2. The standard low fat, low cholesterol diet recommended by the American Heart Association and the National Cholesterol Education Program restricts total fat intake to less than 30% of calories, with 10% derived from each of the three types of fats (saturated, polyunsaturated, and monounsaturated); and dietary cholesterol to less than 300 mg per day. 3. A client whose LDL cholesterol remains elevated after 6 months on the low fat, low cholesterol diet should be considered a candidate for drug therapy. New guidelines from the National Cholesterol Education Program are now available to assist in selecting the appropriate cholesterol lowering drug for clients with high risk hypercholesterolemia. 4. The current national guidelines for treating hypercholesterolemia offer occupational health nurses new opportunities for teaching risk reduction in the workplace.

Recently published guidelines, The Report of the Adult Treatment Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, have tremendous implications for the practice of nursing. This paper presents key elements from that report and discusses how these guidelines can be used to enhance clinical practice among nurses treating and counseling patients with elevated blood cholesterol levels. In addition to discussing the major treatment modalities of diet and drugs, this paper considers implications for nurses working with Black patients.

Nurses have a significant role in the primary prevention of hypercholesterolemia through public and patient education. In addition, nurses have the potential to make significant impact on reducing the cardiovascular risk associated with hypercholesterolemia through effective use of nursing interventions. Early identification of patients with hypercholesterolemia and aggressive life-style modification strategies can lead to a reduction in cholesterol levels and CHD risk.

At least half of all persons in the United States have a serum cholesterol level that places them at high risk for atherosclerosis and its life-threatening complications, particularly coronary heart disease. In the last few years, concern about cholesterol has become a national preoccupation. Concerned consumers increasingly direct their questions about cholesterol to the nurses with whom they come in contact. Nurses who know about cholesterol are in an ideal position to teach current, accurate, potentially life-saving information about it. This article describes the causes, significance, and diagnosis of hypercholesterolemia and outlines the recommendations of the National Cholesterol Education Program (NCEP) panel of experts.

In the last few years, public concern about cholesterol has become a national preoccupation. Concerned consumers increasingly direct their questions about cholesterol to the nurses with whom they come in contact. Nurses in any setting who are knowledgeable about cholesterol are in an ideal position to teach current, accurate, potentially life-saving information about it. Nurses everywhere have a responsibility to assist consumers to achieve the goals of the National Cholesterol Education Program (NCEP) panel of experts within the next few years. This article describes the prevention and control of hypercholesterolemia through dietary and life-style changes. Drug therapy for control of hypercholesterolemia is discussed. Specific nursing interventions that are designed to assist people to achieve the NCEP goals are outlined.

National trials have demonstrated that the incidence of myocardial infarction and coronary death can be decreased, and progression of atherosclerosis delayed or reversed, by administration of bile acid-binding resins. A cholesterol clinic was established to determine whether a simple protocol would be effective in a nonvolunteer population referred by practicing cardiologists. The clinic was operated by a nurse who followed a stepped-care protocol, similar in concept to that used for treatment of hypertension. In the treatment of 86 patients with type II hyperlipidemia (cholesterol level, greater than 6.85 mmol/L [greater than 265 mg/dL]; triglyceride levels, normal or mildly elevated), compliance with the protocol resulted in reductions in cholesterol level of 19% in patients treated with diet, 23% for those treated with diet plus a bile sequestrant (colestipol hydrochloride or cholestyramine resin), and 25% in those treated with diet plus other cholesterol-lowering drugs. This method of treatment was effective and may serve as a model for the management of large numbers of patients with this condition.

Peripheral vascular disease is a chronic progressive disease. Nursing intervention will be aimed at primary prevention through risk factor modification. Quality patient care will be facilitated through the development of an individualized plan of care. An essential element to consider in promoting successful nursing intervention is collaboration of the nurse and patient when developing the plan of care. Overall goals of care for a patient with PVD include promotion of circulation, relief of pain, and prevention of tissue damage or infection.