Article

Trends in high levels of low-density lipoprotein cholesterol in the United States, 1999-2006

Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mailstop K-37, Atlanta, GA 30341-3724, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 11/2009; 302(19):2104-10. DOI: 10.1001/jama.2009.1672
Source: PubMed

ABSTRACT Studies show that a large proportion of adults with high levels of low-density lipoprotein cholesterol (LDL-C) remain untreated or undertreated despite growing use of lipid-lowering medications.
To investigate trends in screening prevalence, use of cholesterol-lowering medications, and LDL-C levels across 4 study cycles (1999-2000, 2001-2002, 2003-2004, and 2005-2006).
The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional, stratified, multistage probability sample survey of the US civilian, noninstitutionalized population. After we restricted the study sample to fasting participants aged 20 years or older (n = 8018) and excluded pregnant women (n = 464) and participants with missing data (n = 510), our study sample consisted of 7044 participants.
High LDL-C levels, defined as levels above the specific goal for each risk category outlined in guidelines from the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). All presented results are weighted and age-standardized to 2000 standard population estimates.
Prevalence of high LDL-C levels among persons aged 20 years or older decreased from 31.5% in 1999-2000 to 21.2% in 2005-2006 (P < .001 for linear trend) but varied by risk category. By the 2005-2006 study cycle, prevalence of high LDL-C was 58.9%, 30.2%, and 11.0% for high-, intermediate-, and low-risk categories, respectively. Self-reported use of lipid-lowering medications increased from 8.0% to 13.4% (P < .001 for linear trend), but screening rates did not change significantly, remaining less than 70% (P = .16 for linear trend) during the study periods.
Among the NHANES population aged 20 years or older, the prevalence of high LDL-C levels decreased from 1999-2000 to 2005-2006. In the most recent period, the prevalence was 21.2%.

Download full-text

Full-text

Available from: Elena Kuklina, Aug 15, 2015
0 Followers
 · 
117 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Previous studies have reported low rates of screening for high cholesterol levels among young adults in the United States. Although recommendations for screening young adults without risk factors for coronary heart disease (CHD) differ, all guidelines recommend screening adults with CHD, CHD equivalents, or 1 or more CHD risk factors. This study examined national prevalence of CHD risk factors and compliance with the cholesterol screening guidelines among young adults. National estimates were obtained using results for 2,587 young adults (men aged 20 to 35 years; women aged 20 to 45 years) from the 1999-2006 National Health and Nutrition Examination Surveys. We defined high low-density lipoprotein cholesterol (LDL-C) as levels higher than the goal specific for each CHD risk category outlined in the National Cholesterol Education Program Adult Treatment Panel III guidelines. About 59% of young adults had CHD or CHD equivalents, or 1 or more of the following CHD risk factors: family history of early CHD, smoking, hypertension, or obesity. In our study, the overall screening rate in this population was less than 50%. Moreover, no significant difference in screening rates between young adults with no risk factors and their counterparts with 1 or more risk factors was found even after adjustment for sociodemographic and health care factors. Approximately 65% of young adults with CHD or CHD equivalents, 26% of young adults with 2 or more risk factors, 12% of young adults with 1 risk factor, and 7% with no risk factor had a high level of LDL-C. CHD risk factors are common in young adults but do not appear to alter screening rates. Improvement of risk assessment and management for cardiovascular disease among young adults is warranted.
    The Annals of Family Medicine 07/2010; 8(4):327-33. DOI:10.1370/afm.1137 · 4.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objetivo. Describir las tendencias en la prevalencia de diabetes tipo 2 (T2D), y otros factores de riesgo cardiovascular como las dislipidemias y la hipertensión en tres encuestas nacionales de salud (1993, 2000 y 2006). Material y Métodos. Las bases de datos de ENEC 1993, ENSA 2000 y ENSANUT 2006 fueron reprocesados para asegurar la comparabilidad entre las encuestas. Resultados. Entre 1993 y 2006 la prevalencia de T2D (6.7-14.4%), síndrome metabólico (26.6-36.8%), hipertensión (23.8-30.7%), hipercolesterolemia (27-43.6%), y LDL-colesterol alto (31.6-46%) aumentaron rápidamente. La prevalencia de concentraciones bajas de HDL-colesterol fue muy alta (60.5-63%) en todas las encuestas, manteniéndose esencialmente sin cambios. Conclusión. La tendencias crecientes en las prevalencias de T2D y factores de riesgo cardiovascular predicen que a corto plazo habrá importantes incrementos en la morbilidad y mortalidad asociada a la T2D y enfermedades cardiovasculares, por lo que deben intensificarse las estrategias para prevenir y reducir los incrementos dramáticos previstos en la carga de enfermedad
    Salud publica de Mexico 01/2010; 52(1). · 0.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Multicast is an important collective communication in scalable parallel computers. One efficient scheme to perform multicast is multidestination messaging. In multidestination messaging, destination nodes of a multicast are partitioned into disjoint groups. Nodes in each group are reached with a multidestination message that conforms to the base routing algorithm of the system. A systematic way of partitioning the nodes is thus critical to multidestination messaging. In this paper we propose a node grouping method, called turn grouping, for partitioning the destination nodes in a multicast. Turn grouping supports any base routing algorithm derivable from the turn model. Simulations based on three turn model-based routing algorithms show that our approach performs better than the some the others
    Frontiers of Massively Parallel Computing, 1996. Proceedings 'Frontiers '96'., Sixth Symposium on the; 11/1996
Show more