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Ann Epidemiol. 2007 Jul;17(7):548-55. Epub 2007 Mar 28.

Trends in ATP-III-defined high blood cholesterol prevalence, awareness, treatment and control among U.S. adults.

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Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.



We sought to determine trends in the prevalence, awareness, treatment and control of high low-density lipoprotein (LDL) cholesterol among U.S. adults.


Data from 6497 participants of the Third National Health and Nutrition Examination Survey (NHANES) conducted in 1988-1994 and 5626 participants of NHANES 1999-2004 were compared. High LDL cholesterol was defined using risk-specific cut-points from the National Cholesterol Education Program's Adult Treatment Panel III guidelines.


The age-standardized percentage of U.S. adults with high LDL cholesterol was 26.6% in 1988-1994 and 25.3% in 1999-2004 (P = 0.28). Between 1988-1994 and 1999-2004, awareness increased from 39.2% to 63.0%, and use of pharmacologic lipid-lowering treatment increased from 11.7% to 40.8% (each p < 0.001). LDL cholesterol control increased from 4.0% to 25.1% among those with high LDL cholesterol (p < 0.001). In 1999-2004, rates of LDL cholesterol control were lower among adults ages 20-49 years compared with those age 65 years or older (13.9% vs. 30.3%; p < 0.001); non-Hispanic blacks and Mexican-Americans compared with non-Hispanic whites (17.2% and 16.5% vs. 26.9%, respectively; p = 0.05 and p = 0.008); and males compared with females (22.6% vs. 28.0%; p = 0.01).


Continued efforts are needed to lower the burden of high LDL cholesterol and increase LDL cholesterol control, especially among populations with low control rates.

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