BODY WATCH : Cholesterol Testing in the Comfort of Your Home

Even though most Americans realize that high levels of total cholesterol are unhealthy, a third don’t know where they stand.

Now, a home cholesterol test promises the answer in 15 minutes for about 15 bucks. While physicians and pharmacists warn that the test shouldn’t substitute for medical attention, they applaud its potential value in raising awareness of health risks.

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Right at Home: Called the Johnson & Johnson Advanced Care Cholesterol Test, it is a repackaged version of the AccuMeter cholesterol test sold to physicians’ offices for their use since 1991, says Alene Holzman of ChemTrak in Sunnyvale. ChemTrak manufactures the test; Johnson & Johnson markets it.

Customers most likely to use the test are “adults ages 25 to 54 who don’t know their number,” says Bill Nealon of Johnson & Johnson’s Advanced Care Products division.

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The ABCs: The kit includes a lancet, gauze pad, bandage, cholesterol result chart, directions and a plastic cassette with a thermometer-like scale and a well to collect blood. The step-by-step directions brochure includes an 800 help line number, staffed by a nurse weekdays from 5 a.m. to 2 p.m. Pacific Standard Time.

Using the lancet, the user pricks a finger to obtain blood (or persuades someone else to do so), lets it drop into the well and waits about 15 minutes. During that time, cholesterol in the blood sample is converted into hydrogen peroxide by two enzymes within the cassette. The more cholesterol, the more hydrogen peroxide is produced. Then the peroxide interacts with a dye and another enzyme, producing color that rises along the thermometer-like scale.

The user then reads the number on the scale and uses the chart provided to convert it to the total cholesterol level.

The test is 97% accurate, according to ChemTrak.

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The Results: Findings are divided into desirable, borderline-high or high, using the same categories as the National Cholesterol Education Program (NCEP), a coalition of private and public organizations. Levels of less than 200 milligrams per deciliter (mg/dl) are deemed desirable. The test brochure advises anyone with levels of 190 or higher to see a doctor.

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Pharmacist’s Input: “If you get high readings, don’t get panicky,” Ryan Chinn, managing pharmacist at Long’s Drugs in Tarzana, has been telling his customers. He began stocking the test in July and says it is selling well. But he reminds those who use it that no test is foolproof and that they should ask a health-care professional if they have concerns or questions. Chinn sees the role of the test as a “broad screening to keep people aware.”

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Physicians’ Input: “We don’t take a stand (on home cholesterol tests) one way or the other,” says Dr. James Cleeman, coordinator of the NCEP. “It’s easy to say the health-care setting is the preferred site (for testing).” But if home tests inspire those who wouldn’t go to a doctor for such a test, he says, “it’s obviously a good thing.”

“If patients using the home test are trying to do their physical at home, it’s counterproductive,” says Dr. Stephen Brunton, a physician at Long Beach Memorial Medical Center. “But if it brings them in to the doctor, that’s good. Anything that makes people more aware of their health status is important.”

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The Score Card: Americans are becoming more savvy about cholesterol, Cleeman says. About 65% of adults have had their total cholesterol measured, he says, most within the last two years. The increase in testing is thought to be spurred by the 1993 recommendation by the NCEP that adults 20 and older be tested not just for total cholesterol, but also for high-density lipoprotein (or HDL cholesterol), the type thought to be protective.

Average total cholesterol levels are dropping, too--from 213 in 1978 to 205 in 1990, the latest statistics.

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Coming Soon: The home test will probably have competition soon. A home test by STC Diagnostics will be on the market within a year, says Dr. Sam Niedbala, a company spokesman. ActiMed Laboratories in Burlington, N.J., is also developing a home test, representative Chris Acker says.

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The Future: Critics of home tests say universal health coverage will eventually include such testing in its basic package. Proponents say the move to universal coverage will put more responsibility on patients, boosting the home-test market.

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On the Horizon: Next up, says ChemTrak’s Holzman, will be a test to measure HDL. The company plans to market it first to physicians, then to consumers.