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CDC: US cholesterol levels declined during past decade
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The percentage of US adults aged at least 20 years with high total cholesterol has declined substantially from 1999-2000 to 2009-2010, according to a recent survey released by the CDC.
In 1999-2000, 18.3% of adults aged at least 20 years had high total cholesterol. According to the survey, this percentage decreased to 13.4% in 2009-2010. In 1999-2000, 17.2% of men had high total cholesterol vs. 12.2% in 2009-2010. In 1999-2000, 19.1% of women had high cholesterol vs. 14.3% in 2009-2010.
The survey also revealed a decreasing trend in high total cholesterol among men aged 40 to 59 years, but the same trend was not observed in women. This decrease was also found among men and women aged 60 years and older, with consistently higher percentages of high total cholesterol still found among women. However, low HDL (<40 mg/dL) was higher for men (31.4%) vs. women (11.9%) from 2009-2010.
The Adult Treatment Panel of the National Cholesterol Education Program recommends that adults be screened for cholesterol to identify those at risk of developing coronary heart disease. In 2005-2006, 65% of men and 71% of women had their cholesterol checked during the past 5 years. Similarly, the survey showed that in 2009-2010, 65.6% of men and 70% of women had their cholesterol checked within the preceding 5 years. Screening rates ranged from 71% in non-Hispanic white women to 50% in Hispanic men. Hispanic men are less likely to be screened than non-Hispanic white or non-Hispanic black men.
CDC. Total and high-density lipoprotein cholesterol in adults: national health and nutrition examination survey, 2009-2010. Available at: www.cdc.gov/nchs/data/databriefs/db92.htm. Accessed April 30, 2012.
Perspective
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Eugene Braunwald, MD
The recent National Health and Nutrition Examination Survey provides a mixed picture on the “cholesterol front.” Somewhat encouraging is the reduction in the percentage of adults with abnormally elevated cholesterol (>240 mg/dL). The good news was that all sex and racial groups achieved the target objective of 17%. Less encouraging was the finding that, while guidelines recommend that all adults should be screened for cholesterol elevation every 5 years, only about two-thirds did so.
The National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) in 2001 regarded a total cholesterol <200 mg/dL (not 240 mg/dL) to be “desirable.” The American Heart Association’s statistics for 2006 showed that 102 million American adults had total cholesterol levels .200 mg/dL, of whom 66.5 million had “undesirable” levels between 200 mg/dL and 240 mg/dL. The next iteration of the NCEP-ATP guidelines, which will be released next year, are certain to be stricter than the 2001 version and will likely inform us that an even higher number of Americans have an “elevated” cholesterol.
A piece of good news, of course, is that undesirably elevated levels of cholesterol can be reduced in virtually everyone by a combination of lifestyle changes and statins. Fortunately, the latter are effective, are usually well tolerated in the low doses required in patients with cholesterol levels between 200 mg/dL and 240 mg/dL and are inexpensive, since many brands are now available in generic forms. The challenge now is to measure total cholesterol — and its fractions — in all adults every 5 years and provide prompt therapy with careful follow-up to the millions in whom cholesterol levels are “undesirable.” Such a strategy will pay off handsomely in further reducing atherosclerotic disease of the coronary, cerebral and lower extremity arteries with an attendant reduction in death and disability, which would be the very best news!
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