Cardiac risk factors in polio survivors

Abstract

Gawne AC, Wells KR, Wilson KS. Cardiac risk factors in polio survivors. Arch Phys Med Rehabil 2003;84:694-6. Objective: To assess the prevalence of dyslipidemia and other risk factors for coronary heart disease in a sample of polio survivors with and without postpoliomyelitis syndrome. Design: Retrospective chart review. Setting: A multidisciplinary outpatient postpolio clinic. Participants: Eighty-eight consecutive symptomatic postpolio patients, 50 women (mean age, 59.0y; range, 36–81y) and 38 men (mean age, 61.2y; range, 44–83y). Interventions: Not applicable. Main Outcome Measures: Presence of risk factors for coronary heart disease: clinical atherosclerotic disease, male age ≥45 years or female age ≥55 years, history of hypertension (blood pressure ≥140/90mmHg or on antihypertensive medication), diabetes mellitus, cigarette smoking, and high-density lipoprotein (HDL) less than 35mg/dL. Obesity (body mass index [BMI], >25kg/m 2) was assessed as an intervention target. Laboratory values included fasting total cholesterol, HDL, low-density lipoprotein, triglycerides, and glucose. Results: Of the total sample, 61.3% had dyslipidemia. Average HDL cholesterol ratio was 4.01 (women, 3.68; men, 4.55). Forty-four patients (50%) had a history of hypertension or had elevated blood pressure. Seven patients (8%) had a history of diabetes or had elevated fasting blood glucose (>110). Eighteen patients (20.4%) were smokers or had a history of smoking; 9 continued to smoke and 9 had quit smoking. Twenty-five patients (28.4%) were overweight (BMI, >25kg/m 2). Forty-one patients (46.5%) had more than 1 risk factor for coronary heart disease. Nine of the total sample (10.2%) had a history of heart disease ranging from atrial fibrillation to angina. Only 19 patients had a previous diagnosis of dyslipidemia and only 12 were on a lipid-lowering medication. Conclusion: Polio patients have a high prevalence of dyslipidemia. The study sample supports the National Cholesterol Education Program’s Adult Treatment Panel III statements that hypercholesterolemia is underdiagnosed and undertreated. The postpolio population carries a high prevalence of 2 or more coronary heart disease risk factors. Evaluation and rehabilitation of polio patients should include screening for dyslipidemia and education about elimination of controllable risk factors.