Implications of Serum Cholesterol Measurement for the Vascular Surgeon

Objective: To measure the serum total cholesterol in new patients with intermittent claudication and to assess the proportion with ischemic heart disease and untreated hypercholesterolemia. Design: A prospective study with patient history corroborated by a general practitioner telephone questionnaire. Setting: A vascular surgical center in a major teaching hospital. Subjects: Seventy-six consecutive claudicants were studied (median age, 66; range, 46 to 94; 45 men and 31 women), of whom 41 (54%) had ischemic heart disease. Results: The median serum total cholesterol concentration was 6.35 mmol/L (IQR, 5.60 to 7.05 mmol/L). Forty-nine (65%) patients had never had their serum cholesterol assayed before this study despite 24 of them having ischemic heart disease. Conclusions: Previously undiagnosed hypercholesterolemia is commonly revealed in the vascular surgical assessment of patients with intermittent claudication. The cardiac morbidity and mortality of these patients is high and surgeons should therefore be proactive in the instigation of cholesterol-lowering therapy.