Trends in Hypercholesterolemia, Treatment and Control Among United States Adults

Background: Control of hypercholesterolemia is an important clinical and public health objective, yet it is generally poor. The objective of this study was to examine trends in the prevalence of hypercholesterolemia, having a cholesterol check, awareness, treatment, and control among United States adults.

Methods: We examined data for 18053 participants aged > or =20 years of the National Health and Nutrition Examination Surveys from 1999 to 2006.

Results: The unadjusted prevalence of hypercholesterolemia ranged from 53.2% to 56.1% and changed little over the study period. Significant increases were evident in the percentage of United States adults who had their concentration of cholesterol checked (from 68.6% to 74.8%), who reported being told that they had high hypercholesterolemia (from 42.0% to 50.4%), who reported using cholesterol-lowering medications (from 39.1% to 54.4%), and who had their hypercholesterolemia controlled (from 47.0 to 64.3%). Among all participants with hypercholesterolemia control of hypercholesterolemia increased from 7.2% to 17.1%. Disparities related to gender and race or ethnicity existed, notably a lower rate of control among women than men and lower rates of having a cholesterol check and reporting being told about hypercholesterolemia among African Americans and Mexican Americans than whites.

Conclusions: Encouraging increases in awareness, treatment, and control of hypercholesterolemia occurred from 1999 through 2006. Nevertheless, control of hypercholesterolemia remains poor.