Blood Cholesterol Measurement Research Articles

Use of the Accutrend Plus point-of-care monitor for blood triglyceride measurement in horses

ELEVATED triglyceride concentrations are a common consequence of negative energy balance in equids (Naylor and others 1980). They are most often observed in overweight ponies, miniature horses and donkeys experiencing...

Inequalities in the provision of cardiovascular screening to people with severe mental illnesses in primary care: Cohort study in the United Kingdom THIN Primary Care Database 2000–2007

BackgroundPeople with severe mental illnesses (SMI), including schizophrenia, are at increased risk of cardiovascular disease (CVD). Guidelines recommend regular CVD screening and in the United Kingdom, since 2004, General Practitioners are remunerated for annual reviews. ObjectivesTo compare annual rates of CVD screening provision in people with and without SMI between 2000 and 2008. MethodWe identified 18,696 people with SMI and 95,512 people without SMI in the UK The Health Improvement Network (THIN) primary care database. We compared the rates of measurement of blood pressure (BP), glucose, cholesterol and body mass index (BMI). ResultsPrior to 2004, all people with SMI, were significantly less likely to receive each measurement, (including people above and below 60years of age). In 2003; adjusted incidence rate ratios (95% CI) for screening in people with SMI under 60years compared to people without SMI were: BMI: 0.62 (0.58–0.65); BP: 0.59 (0.56–0.62); glucose: 0.66 (0.61–0.70) and cholesterol: 0.54 (0.49–0.59). By 2007 people with SMI under 60 were equally likely receive a measurement of BMI: 1.00 (0.96–1.04), glucose: 1.00 (0.96–1.05) and cholesterol: 0.95 (0.90–1.0); the gap in screening for BP had narrowed 0.87 (0.83–0.90). However people with SMI over 60years of age remained significantly less likely to be screened. There was little difference in screening according to social deprivation. ConclusionsIn UK primary care, people with SMI over 60years of age remain less likely than the general population to receive annual CVD screening despite higher risk of developing CVD.

The provision of current and future Healthy Weight Management (HWM) services from community pharmacies: a survey of community pharmacists' attitudes, practice and future possibilities

The extent to which community pharmacists contribute to the management of the global obesity epidemic is unclear. Local, regional and national obesity management schemes need to be informed by existing services which will be influenced by health professionals' attitudes and willingness to engage in service provision. The purpose of this study was to derive an accurate account of community pharmacists' activities and attitudes towards the provision of current and future Healthy Weight Management (HWM) services. A postal survey was developed and disseminated to all 128 community pharmacies in Grampian, north-east Scotland. The response rate was 64.8% (83/128). A range of HWM services was already being provided. The most common services offered were the supply of weight-loss medication (n=69, 84.1%) and advice about its use (n=68, 84.0%). Other services commonly offered were dietary advice (n=59, 72.8%), physical activity advice (n=53, 66.3%) and body mass index (BMI) calculation (n=56, 68.3%). Most pharmacists were confident in measuring weight (n=78, 93.9%), height (n=78, 93.9%) and BMI (n=78, 93.9%). Many pharmacists perceived a need for HWM services in their local area (n=56, 67.5%) as well as a need to extend these services within their pharmacies (n=48, 57.9%). Barriers to the provision of HWM services included workload (n=77, 92.8%) and the need for additional reimbursement (n=63, 75.9%) and additional staff (n=49, 59.7%). The pharmacists' perceived training needs included estimation of body fat (n=67, 81.7%), one-to-one consultation skills (n=60, 73.2%), advice on weight-loss products (n=52, 63.4%), measurement of blood cholesterol (n=51, 63%) and advice on weight-loss drugs (n=49, 60.5%). Community pharmacies could be an ideal setting for the provision of HWM services. The barriers to service provision need to be addressed. Furthermore, the development of appropriate undergraduate and postgraduate training is required to equip pharmacists and their staff with appropriate knowledge and skills to deliver these services effectively.

Implementation of a simple age‐based strategy in the prevention of cardiovascular disease: the Polypill approach

A combination of medications that simultaneously reduce several cardiovascular risk factors in people above a specified age, without selection based on risk factor measurement, has been proposed as a simple strategy for reducing the risk of cardiovascular disease and shown to be effective in randomized trials (the Polypill approach). To assess acceptance of the Polypill approach and adherence to preventive treatment among individuals taking part in a cardiovascular disease prevention service. Daily treatment with simvastatin (40 mg), amlodipine (2.5 mg), bendroflumethiazide (1.25 mg), lisinopril (5 mg) [or candesartan (4 mg) if cough was reported] and folic acid (0.8 mg) was offered, as separate components, to people ≥ 55 years with no history of cardiovascular, renal or liver disease. An audit of adverse effects, adherence and requests for blood pressure and cholesterol measurement was determined by telephone consultation. Between 2006 and 2010, 269 participants started treatment with the Polypill components. Follow-up ranged from 3 to 48 months (mean 20). A total of 222 participants (83%) adhered to treatment, including 30 (11%) who switched from the angiotensin-converting enzyme inhibitor (lisinopril) to the angiotensin receptor blocker (candesartan) because of cough. Ten participants (4%) continued to take treatment but stopped taking one or more drugs because of other symptoms, and 37 (14%) stopped all treatment, eight because of adverse effects and 29 for non-medical reasons. No one requested a blood pressure or cholesterol measurement. This is the first demonstration of the application of the Polypill approach in practice. The method was accepted and the Polypill components were well tolerated, with good adherence and no demand for information about risk factors.

Participation in health check-ups and mortality using propensity score matched cohort analyses

Objective All Japanese aged ≥ 40 years are eligible for free annual health check-ups including blood pressure and cholesterol measurements. It is well known that health check-up screenees are more likely to have healthy lifestyles and better health conditions than non-screenees. Therefore, controlling these factors is required to investigate whether screenees have a lower mortality risk than non-screenees independent of their lifestyles or health conditions. Methods We followed 48,775 Japanese National Health Insurance beneficiaries aged 40–79 years since 1994 for 11 years. We used Cox proportional hazard models adjusted for possible confounding factors. We also performed propensity for use of the health check-up matched cohort analyses. Results Compared to non-screenees, multiple-adjusted hazard ratios (95% confidence intervals) for all-cause and cardiovascular disease mortality among screenees were 0.74 (0.62–0.88) and 0.65 (0.44–0.95) for men and 0.69 (0.52–0.91) and 0.61 (0.36–1.04) for women, respectively. These relations were also observed when we used propensity matched cohort analyses. Conclusion This is the first study to show that mortality rates are lower among screenees than non-screenees in Japanese health check-ups when propensity matched cohort analyses were used for adjusting confounding factors. Further prospective studies, including randomized controlled trials, are required to confirm whether screening lowers mortality.

Cardiometabolic treatment decisions in patients with type 2 diabetes: the role of repeated measurements and medication burden

PurposeClinical guidelines for cardiometabolic risk management indicate a simple threshold-based strategy for treatment, but physicians and their patients may be reluctant to modify drug treatment after a single elevated measurement....

Cardiovascular risk factor assessment after pre-eclampsia in primary care

BackgroundPre-eclampsia is associated with an increased risk of development of cardiovascular disease later in life. It is not known how general practitioners in the Netherlands care for these women after delivery with respect to cardiovascular risk factor management.MethodsReview of medical records of 1196 women in four primary health care centres, who were registered from January 2000 until July 2007 with an International Classification of Primary Care (ICPC) code indicating pregnancy. Records were searched for indicators of pre-eclampsia. Of those who experienced pre-eclampsia and of a random sample of 150 women who did not, the following information on cardiovascular risk factor management after pregnancy was extracted from the records: frequency and timing of blood pressure, cholesterol and glucose measurements - and vascular diagnoses. Additionally the sensitivity and specificity of ICPC coding for pre-eclampsia were determined.Results35 women experienced pre-eclampsia. Blood pressure was more often checked after pregnancy in these women than in controls (57.1% vs. 12.0%, p < 0.001). In 50% of the cases blood pressure was measured within 3 months after delivery with no further follow-up visit. A check for glucose and cholesterol levels was rare, and equally frequent in PE and control women. 20% of the previously normotensive women in the PE group had hypertension at one or more occasions after three months post partum versus none in the control group. The ICPC coding for pre-eclampsia showed a sensitivity of 51.4% and a specificity of 100.0%.ConclusionDespite the evidence of increased risk of future cardiovascular disease in women with a history of pre-eclampsia, follow-up of these women is insufficient and undeveloped in primary care in the Netherlands.

Metabolic Syndrome in Children and Adolescents: Prevalence, Public Health Issue, and Time for Initiative

Screening for features of the metabolic syndrome is being recommended by many learned societies and scientists in the field. Guidelines and recommendations as to how and whom to screen still vary from country to country and are not solely based on evidence from large, longitudinal studies. Whether the term ‘‘metabolic syndrome’’ is of clinical relevance in children and adolescents and more meaningful than individual components such as hypertension, insulin resistance, and type 2 diabetes mellitus or dyslipidemia is still open for debate. In addition, comorbidities of obesity such as sleep-disordered breathing and sleep apnea even at a young age have been recognized more recently. Nevertheless, along with the increasing prevalence of obesity in childhood and adolescence, the existence of the metabolic syndrome in obese children and adolescents is being recognized. The prevalence of any feature of the metabolic syndrome is being reported to be up to 30%, irrespective of the definition that is applied. Signaling molecules, termed adipocytokines, secreted from the adipose tissue, are thought to play a major role in the pathophysiology of the metabolic syndrome. Leptin and its soluble receptor may be more important in states of energy deficiency rather than as a predictor of the metabolic syndrome in

Prevalência de fatores de risco cardiovascular em trabalhadores de uma indústria brasileira

Determining the cardiovascular risk factors is essential for the primary and secondary prevention of circulatory system diseases.To obtain the prevalence of cardiovascular risk factors in a population of industry workers in Brazil.Transversal cohort study, with a sociodemographic interview to identify cardiovascular risk factors, anthropometric and blood pressure measurements and capillary blood collection for blood glucose, cholesterol and triglyceride measurement in food industry workers of both sexes.A total of 1,047 workers were assessed, with 913 (87%) of them being males, with a mean age of 36 +/- 8 years. The frequency of a sedentary lifestyle was 83% and of overweight, 63%. Systemic arterial hypertension was identified in 28% of the individuals and 45% were in the pre-hypertension range. Alterations in the blood glucose levels were identified in 49% of the participants, as well as high levels of cholesterol and triglycerides in 7% and 11% of the population, respectively. The body mass index (BMI) levels were not associated to income, but there was an inverse association with the level of schooling.Overweight and a sedentary lifestyle are the main cardiovascular risk factors in a population of industry workers.

Awareness, treatment and control of hypertension: the ‘rule of halves’ in an era of risk-based treatment of hypertension

Detection, treatment and control of high blood pressure in many populations are insufficient. We reported current prevalence, awareness, treatment and control of hypertension in the Netherlands and compared the findings with other studies. Furthermore, we related actual treatment of hypertension to estimated absolute 10-year cardiovascular risk, as according to current guidelines on this subject, initiation of blood pressure-lowering treatment depends on the level of cardiovascular risk. The Utrecht Health Project is a prospective cohort study in a suburb of Utrecht. Information on medical history, life style and measurements of blood pressure, cholesterol and glucose of the first 4950 participants of the study was obtained. Cardiovascular risks were calculated using the Framingham risk function. Prevalence of hypertension was 23.3%. Among those with hypertension, 33.7% was aware of the condition. Of those aware, 59.4% was treated. Of those treated, 41.9% had blood pressure below the recommended level. In half of those aware of their hypertension, and a calculated cardiovascular risk less than 10%, treatment of hypertension was started unnecessary. Of those aware of their hypertension with a calculated cardiovascular 10 years risk exceeding the treatment threshold of 20%, treatment was absent in 33.6%. Awareness and control of hypertension are still inadequate in the Netherlands and comparable with other European countries. Management of hypertension is too often not risk-based despite recommendations in guidelines on prevention of cardiovascular diseases available since 2000.

The relationships between risk factors and the distribution of retinopathy lesions in type 2 diabetes

Previous studies have shown that the progression of diabetic retinopathy to vision-threatening lesions may be related to the development of retinopathy lesions in specific retinal areas. The purpose of the present study was to examine whether the occurrence of retinopathy in these retinal areas is related to known risk factors for progression of retinopathy in type 2 diabetes. A total of 377 randomly selected patients with type 2 diabetes underwent examinations which included measurement of blood pressure, haemoglobin A1c and cholesterol, and a full eye examination including fundus photography. The fundus photographs were digitized and a computer-assisted technique was used to quantify retinopathy lesions in the macular area, around the vascular arcades and in the retinal periphery. Only the number of microaneurysms/haemorrhages was sufficient for statistical analysis. Patients with retinopathy had significantly longer diabetes duration, and higher blood pressure and HgbA1c than patients without retinopathy. However, among the patients with retinopathy there was no correlation between these risk factors and the overall number of microaneurysms/haemorrhages or the number of these lesions in the local areas of the fundus studied. The localized distribution of retinopathy lesions does not correlate with known risk factors and background factors for the development of diabetic retinopathy in the early stages of the disease. Future improvements of grading systems for diabetic retinopathy should focus on a quantification of the overall number and dynamics of retinopathy lesions in the early stages of retinopathy and the regional distribution and dynamics of lesions in more advanced stages of retinopathy.

Thematic review series: The Pathogenesis of Atherosclerosis. An interpretive history of the cholesterol controversy, part IV: The 1984 Coronary Primary Prevention Trial ends it—almost

As of the early 1980s, despite the wealth of evidence from experimental animal models, the extensive epidemiologic evidence, the powerful genetic evidence, and the strongly suggestive clinical intervention trial results, most clinicians still remained unpersuaded regarding the relevance of the lipid hypothesis. What was needed was a well-designed, large-scale, long-term, double-blind study demonstrating a statistically significant impact of treatment on coronary heart disease events. The National Institutes of Health (NIH) had laid the groundwork for such a study as early as 1970, but the study was not completed and the results published until 1984. This study, the Coronary Primary Prevention Trial, showed that treatment with a bile acid binding resin reduced major coronary events in hypercholesterolemic men by 19%, with a P value of 0.05. The NIH followed this up with a national Consensus Development Conference on Lowering Blood Cholesterol to Prevent Heart Disease. For the first time, the NIH now went on record advocating screening for hypercholesterolemia and urging aggressive treatment for those at high risk. The Institute initiated a national cooperative program to that end, the National Cholesterol Education Program. For the first time, preventing coronary heart disease became a national public health goal.

Combined Effects of Systolic Blood Pressure and Total Cholesterol on Cardiovascular Disease Risk

Half of all adult deaths (and much severe disability) are caused by cardiovascular diseases, and most of these deaths involve ischemic heart disease or stroke. The Asia-Pacific region accounts for about half of the global burden of cardiovascular disease and the proportion is likely to increase during the next few decades.1,2 Smoking and elevated levels of systolic blood pressure (SBP) and total blood cholesterol are major causes of cardiovascular disease,3 yet much of our knowledge about the associations between these risk factors and cardiovascular diseases comes from studies carried out in North American and western European countries. In most Asian countries, however, the mean levels of total cholesterol are lower than those found in Western countries and the incidence of coronary heart disease (CHD) is also lower, whereas the incidence of stroke, particularly hemorrhagic stroke, is higher. Article p 3384 The Asia Pacific Cohort Studies Collaboration report in this issue of Circulation investigates the combined effects of SBP and total cholesterol on risk of cardiovascular disease in a meta-analysis of 36 cohort studies (29 conducted in Asia and 7 from Australia and New Zealand) involving 380 000 individuals.4 This meta-analysis differs from previous studies in several ways: It is the largest study from this region, involving >3000 CHD events and 4000 stroke events; individual records were available for each of the participants in each study, with cause and age of death (if applicable); and information on several thousand repeat measurements of blood pressure and cholesterol made during prolonged follow-up allowed correction for “regression dilution.” These features …

Central Obesity and the Aging Brain

Central adiposity as an indicator of visceral fat is linked to vascular and metabolic factors that in turn are related to cognitive decline and dementia. To determine whether larger waist-hip ratio (WHR) is associated with structural brain changes that underlie cognitive decline and dementia. Cross-sectional analysis of an epidemiologic cohort study of cognitive and functional decline (Sacramento Area Latino Study on Aging). California Central Valley. A total of 112 individuals selected from an ongoing cohort study of 1789 older Latino individuals. Baseline anthropomorphic measures (WHR) and measurements of fasting blood glucose, cholesterol, and insulin levels and blood pressure were obtained. Baseline magnetic resonance images were analyzed quantitatively to determine the hippocampal volumes in the right and left hemispheres and rated for the percentage of white matter hyperintensities. Greater WHR (P = .02) and older age (P<.001) were negatively related to hippocampal volumes. The WHR and age were positively related to white matter hyperintensities (P = .02 and P = .001, respectively). A 1-SD increase in WHR was associated with a 0.2-SD decrease in hippocampal volume and a 27% increase in white matter hyperintensities. These relationships were not affected by adjustment for body mass index, total cholesterol, fasting blood glucose, and insulin levels or systolic blood pressure in the models. A larger WHR may be related to neurodegenerative, vascular, or metabolic processes that affect brain structures underlying cognitive decline and dementia.

Cardiovascular disease risk reduction in the Behavioral Risk Factor Surveillance System

Background Cardiovascular disease (CVD) risk-reduction practices are suboptimal in populations at high risk for CVD, and this problem may be worse in women than in men. Methods In 2003, CVD risk-reduction practices were compared between men and women after stratification by CVD risk status (high, intermediate, low) in a cross-sectional analysis of the 1999 Behavioral Risk Factor Surveillance System (BRFSS), a random-digit telephone survey of state population-based samples of the civilian non-institutionalized population of adults. This analysis included persons aged >40 years who answered questions regarding lipid and blood pressure screening, recommendations for lifestyle modification, that is, exercise and reduced fat intake, and aspirin use. Risk status was defined according to Adult Treatment Panel III definitions. Results In the 97,387 adults included in this analysis, high CVD risk was associated with lipid and blood pressure screening, lifestyle modification, and aspirin use in both men and women compared to intermediate-risk and low-risk ( p <0.001). Among high-risk adults, men and women reported similar frequency of blood pressure and cholesterol measurement and physician advice on lifestyle modification; among intermediate- and low-risk adults, women reported slightly more frequent screening and lifestyle modification than men ( p <0.001). In all CVD risk categories, women reported significantly less aspirin use than in men ( p <0.001). Conclusions Among people at high risk for CVD, women report lifestyle modification more often than men, while men report use of aspirin more often than women. These findings may assist with targeting interventions to reduce CVD risk to the unique needs of men and women.

Cracovian program for secondary prevention of ischaemic heart diseaseSecondary prevention of ischaemic heart disease during hospitalisation in 1996/1997 and 1998/1999

Aim Hospitalisation due to ischaemic heart disease is a crucial moment for initiation of the secondary prevention of ischaemic heart disease. The aim of the study was to compare quality of medical care in the field of secondary prevention in Cracow cardiac departments between 1996–1997 and 1998–1999. Methods and results The study was carried out in six cardiac departments serving the area of the city and its province (1.2 mln inhabitants). Consecutive patients were identified according to the following categories: acute myocardial infarction, unstable angina, PCI or CABG. In total, we reviewed the hospital records of 1051 patients. The rate of available information on hypercholesterolemia, hypertension and diabetes prior to hospitalisation as well as the percentage of medical records with available information on blood pressure, total cholesterol, weight and height measurements increased significantly in 1998–1999 compared to 1996–1997. In addition, the frequency of prescribing antiplatelet and lipid-lowering drugs at discharge increased significantly in 1998–1999. The variation among participating departments in the rate of available information on risk factors prior to hospitalisation and on blood pressure and cholesterol measurements decreased in 1998–1999, as did the variation in the use of antiplatelets, ACE-inhibitors and lipid-lowering drugs. Conclusions The integration of ischaemic heart disease prevention into clinical practice in Cracow cardiac departments improved in 1998–1999 compared to 1996–1997. The biggest improvement could be observed in departments with the poorest quality of clinical care at baseline.

The importance of cholesterol, blood pressure and smoking for coronary heart disease

See doi:10.1016/S1095-668X(03)00471-8 for the article to which this editorial refers Worldwide cardiovascular diseases account for half of all deaths in middle age (and considerable additional disability) and one third of all deaths in old age. Most of these deaths involve ischaemic heart disease (IHD) or stroke. Epidemiological studies carried out over the last half century have shown that cigarette smoking, elevated blood pressure and dyslipidaemia increase the risk of cardiovascular diseases and randomized trials have shown that lowering blood pressure and cholesterol prevents cardiovascular disease. Nevertheless, there are popular misconceptions about the relative importance of these classical risk factors, including the widely held belief that they only account for about half of all cardiovascular diseases.1 The underestimation of the importance of these risk factors has arisen from analyses of prospective cohort studies in which measurements of blood pressure or cholesterol recorded on enrolment to the study (the ‘baseline’ survey) were related to subsequent risk of developing IHD. But, due to the combined effects of measurement errors, short-term biological variability and longer-term systematic changes within individuals, baseline measurements often do not reliably indicate the long-term average, or ‘usual’, level of a risk factor either at around the time of the baseline measurement or during a later …

Is elbow breadth a measure of frame size in non-Caucasian Populations? A study in low- and high-altitude Central-Asia Populations

The concept of frame size has not undergone a thorough evaluation in non-Caucasian populations. Using data from the Central Asia High Altitude Population (CAHAP) study, we tested whether: (1) the relationship between frame size and body composition is different in high-, medium- and low-altitude populations; (2) elbow breadth is a better index of frame size than biacromial and biiliac breadth; and (3) measures of frame size are associated with blood pressure, cholesterol and triglycerides. A number of 334 male subjects aged 33±10 years (mean±standard deviation) were selected from the CAHAP population (n=384) on the basis of the availability of breadth measurements. The subjects were 85 high-altitude Kirghizs, 105 medium-altitude Kazakhs, 79 low-altitude Kirghizs and 65 low-altitude Uighurs. A detailed anthropometric evaluation and blood pressure, cholesterol and trygliceride measurements were performed on all individuals. Among breadths, elbow had the lowest correlation with arm fat area, thigh fat area, calf fat area and the sum of trunk skinfolds (r≤⃒0.196, P<0.01). Even if elbow breadth did not have the highest correlation with muscularity indexes, its constantly lower association with adiposity indexes shows that it is a better measure of frame size than biacromial breadth and biiliac breadth. The relationship between frame size and body composition did not differ in high-, medium- and low-altitude subjects (P=not significant, analysis of co-variance). Only a weak association was present between breadths, blood pressure, cholesterol and triglycerides (r≤⃒0.230, P<0.01) and it was not influenced by altitude (P=not significant, analysis of co-variance). Elbow breadth was significantly correlated only with diastolic blood pressure (r=0.121, P<0.05). In conclusion: (1) the relationship between frame size and body composition is similar in high- and low-altitude populations; (2) elbow breadth is an index of frame size independent of altitude; and (3) elbow breadth is correlated with diastolic blood pressure, but this correlation is of doubtful biological relevance.

Hypertension is frequently present in patients with reflux esophagitis or Barrett’s esophagus but not in those with non-ulcer dyspepsia

Background: Elevated mortality due to cardiovascular disease has been reported for patients with Barrett’s esophagus (BE). We compared the prevalence of risk factors for cardiovascular disease in patients with BE, reflux esophagitis (RE), and non-ulcer dyspepsia (NUD) with that of the general population. Methods: Patients with upper gastrointestinal complaints and BE, RE, or NUD were compared with a matched cohort from the general population using a questionnaire and blood pressure and cholesterol measurements. Results: Hypertension occurred more frequently in patients with BE (odds ratio 5.1, P<0.0001) and RE (odds ratio 3.8, P<0.001), but not in those with NUD. Serum total cholesterol was higher in BE ( P=0.02) and borderline in RE ( P=0.06) but not in NUD. Mean HDL cholesterol levels, body mass index, and smoking did not differ. Conclusions: This study suggests that BE and RE found at diagnostic endoscopy are associated with an increased prevalence of hypertension and a higher total cholesterol level than in the general population. If so, this would explain the increased mortality during the follow-up of BE patients, and it should be taken into account when designing or evaluating follow-up studies of BE.

Racial and ethnic disparity in blood pressure and cholesterol measurement.

To evaluate racial and ethnic disparity in blood pressure and cholesterol measurement and to analyze factors associated with any observed disparity. Cross-sectional analysis of the household component of the 1996 Medical Expenditure Panel Survey. Representative sample of the U.S. non-institutionalized population age 21 or older. Prevalence of self-reported blood pressure measurement within 2 years and cholesterol measurement within 5 years were calculated by race/ethnicity. Logistic regression was used to adjust for health insurance status, having a usual source of care, health status, and socioeconomic and demographic factors. Odds ratios and 95% confidence intervals (95% CIs) from the logistic regression were converted to prevalence ratios to estimate relative risk (RR). Mexican Americans compared to non-Hispanic whites were less likely to have a blood pressure measurement (RR, 0.85; 95% CI, 0.81 to 0.89) or a cholesterol measurement (RR, 0.72; 95% CI, 0.65 to 0.78). Non-Hispanic blacks had blood pressure and cholesterol measurements similar to non-Hispanic whites. In a multivariate analysis, Mexican Americans had similar blood pressure measurements (RR, 0.97; 95% CI, 0.94 to 1.00) and cholesterol measurements (RR, 1.04; 95% CI, 0.99 to 1.08). The factors associated with the largest disparity were lack of health insurance, not having a usual source of care, and low education. No disparity was found between non-Hispanic blacks and non-Hispanic whites in undergoing blood pressure and cholesterol measurement. Disparities in cardiovascular preventive services for Mexican Americans were associated with lack of health insurance and a usual source of care, but other demographic and socioeconomic factors were also important.