Wellness Program Blog

A program is required to offer appropriate interpretation of blood lipid evaluation results, including a caution that a single measurement neither excludes nor establishes a diagnosis of their blood cholesterol.

Follow national standard procedures:

Total Cholesterol
Desirable cholesterol    < 200 mg/dl
Borderline cholesterol    200 – 239 mg/dl
High cholesterol    > 240 mg/dl

HDL
Desirable HDL     > 35 mg/dl
Low HDL     < 35 mg/dl

Refer blood lipid evaluation participants to medical care as follows:

Total Cholesterol
< 200 mg/dl     Recheck blood lipid in five years, if history of coronary heart disease or if two or more CHD risk factors are detected refers to risk reduction program or health professionals, as appropriate.
200 – 239 mg/dl     If history of CHD or if two or more other risk factors are detected, refer to medical care or risk reduction service within two months; if no stated history of CVD or less than two other risk factors, reassess blood lipid status within 1-2 years.
> 240mg/dl     Refer to medical care within two months.

HDL
> 35 mg/dl    If fewer than 2 risk factors and borderline total cholesterol, refer to risk reduction service, as appropriate. Reassess HDL in 1-2 years.

Provide the following:
• The relationship of blood lipids, elevated Blood Pressure (BP), and other risk factors.
o Risk factors include: elevated Blood Pressure (BP) 140/90 or higher or on hypertension medication; current tobacco use; family history of premature CHD; diabetes mellitus; age – male > 45 years, female > 55 years or premature menopause without estrogen replacement therapy.
o Negative risk factor: high HDL 60 mg/dl or greater (subtract one risk factor).
o Risk factors such as family history, smoking, high fat or other unhealthy diet, and lack of exercise lead to the development of cardiovascular disease (CVD).
• Definitions and causes of elevated blood lipids and HDL, desirable levels, the meaning and limitations of a single measurement, the cause of variability, and the need for multiple measurements prior to diagnosis.
• Wide range of treatment options, including diet (e.g., effect of controlling fat intake less than 30% of total calories from fat, less 10% saturated fats), less than 300 mg. of cholesterol per day, well-balanced diet, weight maintenance or reduction, exercise, and medication.
• Importance of following prescribed treatment and professional advice.

Appropriate medical care or allied health professional trained in measurement of Blood Pressure (BP), referral protocols, and delivering educational messages to colleague conducting Blood Pressure (BP) programs. These programs are required to follow national standard procedures.

• National standard procedures for Blood Pressure (BP) protocols:
o Calibration of Blood Pressure (BP) calculating equipment
be done at least each year.
o Two or more measurements of colleague’s Blood Pressure (BP) ought to be taken.
o Referral of participants with elevated Blood Pressure (BP) readings to personal physician for further assessment.

• Systolic/Diastolic Follow-Up:
o Normal:   <130 / <85
Action: Recheck in 2 years
o High Normal:   130-139 / 85-90
Action: Recheck in 1 year

• Hypertension:
o Stage 1 (Mild):   140-159 / 90-99
Action: Confirm within 2 Months.
o Stage 2 (Moderate):   160-179 / 100-109
Action: Refer to source of care within 1 month.
o Stage 3 (Severe):   180-209 / 110-119
Action: Refer to source of care within 1 week.
o Stage 4 (Very Severe):   >210 / >120
Action: Refer to source of care immediately.

• Appropriate educational messages:
o Normal:   <130 systolic and <85 diastolic
Action: No referral. If on treatment, then inform colleague that Blood Pressure (BP) is under great control today and ought to continue seeing and following treatment program.
o High Normal:   130-139 systolic and/or 85-89 diastolic
Action: Recommend that colleague have Blood Pressure (BP) rechecked within 1 year unless under treatment. Advise colleague that the readings are in a high normal range that needs rechecking. In the interim, suggest that one of the most effective means to decrease Blood Pressure (BP) is to bring weight into normal range and to exercise.
o High:   >140 systolic and/or >90 diastolic
Action: Refer to physician for further assessment within 2 months unless the level is within urgent, emergency, or isolated systolic hypertension levels. If already on treatment, advise colleague of readings and need to get Blood Pressure (BP) to a objective of 140/90 or less.
o Isolated Systolic Hypertension:   140-159 systolic and < 90 diastolic in a colleague 65 years of age or older.
Action: Advise colleague to inform physician of readings at next visit and consider advice regarding weight loss and exercise if appropriate.
o Urgent:   180-209 systolic and/or 110-119 diastolic
Action: Recommend obtaining medical care assessment within 1 week.
o Emergency:   >210 systolic and/or >120 diastolic
Action: Obtain immediate medical care attention.

• Provides the following:
o Written results, referral standard procedures, and an explanation of Blood Pressure (BP) levels given to each colleague with individualized counseling, including advice about the interval of time recommended when the colleague ought to be checked again.
o Utilizes the recommendations in The Fifth Report Of The Joint National Committee on Detection, Evaluation and Treatment of High Blood Pressure (BP), March 1994.
o Written and audiovisual materials that are informative, easy to be aware of, and useful while containing scientifically accurate information.
o Relationship of elevated Blood Pressure (BP) and other risk factors, such as family history, smoking, high fat and unhealthy diet, lack of exercise, in the development of cardiovascular disease, including stroke, kidney disease, heart attack, and other diseases.
o Definition and causes of elevated Blood Pressure (BP).
o Importance of following prescribed treatment.