June 1991

Costs and Health Consequences of Cholesterol Screening for Asymptomatic Older Americans

Author Affiliations

From the Division of General Internal Medicine, Stanford (Calif) University School of Medicine and Department of Veterans Affairs Medical Center, Palo Alto, Calif (Dr Garber); Department of Medicine, Dartmouth-Hitchcock Medical Center, Hanover, NH (Drs Littenberg and Sox); and Office of Technology Assessment, US Congress, Washington, DC (Drs Wagner and Gluck).

Arch Intern Med. 1991;151(6):1089-1095. doi:10.1001/archinte.1991.00400060037007

To predict the consequences of cholesterol screening among elderly Americans who do not have symptoms of heart disease, we explore the cost implications of a cholesterol screening program, evaluate evidence linking hypercholesterolemia to coronary heart disease and mortality in the elderly, and describe the likely effects of therapy of hypercholesterolemia. According to our calculations, if all Americans 65 years of age and older adhered to a cholesterol screening program similar to the one proposed by the National Cholesterol Education Program, minimum annual expenditures for screening and treatment would be between $1.6 billion and $16.8 billion, depending on the effectiveness of diet and the cost of the medications used to treat hypercholesterolemia. There is no direct evidence that this program would lessen overall morbidity or extend the lives of elderly Americans.

(Arch Intern Med. 1991;151:1089-1095)