Women of Childbearing Age Have Low Lipid Screening Rates

New research to be presented at ACC.19 in New Orleans will show that 8 out of 10 women of childbearing age have never had cholesterol levels checked.

The research team from the University of Pennsylvania, seeking to tease out screening patterns for hyperlipidemia, looked at cholesterol screening data on 5,101 women who gave birth at the University of Pennsylvania Hospital between 2009 and 2018, and who had a postpartum visit within 180 days of delivery.

“Not nearly as many people as we think are actually getting cholesterol screening despite very clear recommendations,” said lead author Dipika J. Gopal, MD, a fellow in the cardiovascular division at Hospital of the University of Pennsylvania, in an ACC press release. “In fact, the number of patients who have ever been screened was staggeringly low, perhaps because they’re either not going to their primary care doctor or their doctor isn’t ordering the test.”

The results indicated that only 1,112 (22%) patients had their cholesterol checked at least once during pregnancy. Of those women who had received screening, 83 (7%) had elevated cholesterol and triglyceride levels. The researchers also report that the women who did receive screening were more likely to be older, white, and have coronary artery disease, hypertension and diabetes. The women in the study ranged in age from 21 to 60 years and met all met criteria to have had cholesterol checked at least once, if not multiple times. Current ACC/AHA guidelines recommend pharmacological intervention at LDL cholesterol levels > 190 mg/dL; researchers for this study set the cutoff at 130 mg/dL. The researchers reported that 20% of the screened women had LDL levels >130 mg/dL, and 5% had LDL >160 mg/dL.

“Finding and treating FH early is particularly critical,” Gopal said. “If we can optimize cholesterol screening per the ACC/AHA guideline, we would more routinely identify inherited diseases and be able to do a cascade of testing and change the trajectory of a family’s life because it’s not just that woman, it’s also her children and other blood relatives who might be affected.”

About one in three American adults has high cholesterol, according to the press release. Dr. Golap said that future research should look at implementing “a screening lipid panel and cardiovascular risk assessment as part of prenatal visits.”