Twenty-Year Trends in Serum Cholesterol, Hypercholesterolemia, and Cholesterol Medication Use The Minnesota Heart Survey, 1980–1982 to 2000–2002

Department of Nutrition, University of Oslo, Kristiania (historical), Oslo, Norway
Circulation (Impact Factor: 14.43). 12/2005; 112(25):3884-91. DOI: 10.1161/CIRCULATIONAHA.105.549857
Source: PubMed


Although US cholesterol concentrations have dropped, &50% of adults have total cholesterol concentrations > or =5.18 mmol/L, putting them at "borderline-high risk" for heart disease. Whether the decline has continued into the 21st century is unknown. We assessed 20-year trends in cholesterol, hypercholesterolemia, lipid-lowering drug use, and cholesterol awareness, treatment, and control from Minnesota Heart Survey (MHS) data.
Five independent, cross-sectional, population-based surveys of 2500 to 5000 adults were conducted in the Minneapolis-St. Paul, Minn, area from 1980 to 2002. Mean (nonfasting) total cholesterol concentrations have continued a 20-year decline, punctuated by an intervening lull. Age-adjusted mean total cholesterol concentrations in 2000 to 2002 were 5.16 and 5.09 mmol/L for men and women, respectively (in 1980 to 1982, 5.49 and 5.38 mmol/L for men and women, respectively) However, the decline has not been uniform across all age groups. Middle-aged to older people have shown substantial decreases, but younger people have shown little overall change and recently had increased total cholesterol values. The mean prevalence of hypercholesterolemia in 2000 to 2002 was 54.9% for men and 46.5% for women and has decreased significantly for both during the study. Age-adjusted mean high-density lipoprotein cholesterol concentrations in 2000 to 2002 were 1.09 and 1.40 mmol/L for men and women, respectively, and were not different from the prior survey. Lipid-lowering drug use rose significantly for both sexes aged 35 to 74 years. Awareness, treatment, and control of hypercholesterolemia have increased; however, more than half of those at borderline-high risk remain unaware of their condition.
Although hypercholesterolemia prevalence continued to fall, significant population segments still have cholesterol concentrations near or at the level of increased risk.

Full-text preview

Available from:
  • Source
    • "An attempt to decrease the number of people suffering from lipid disorders, as well as to increase the detection and enhance the effectiveness of treating these abnormalities, have become priorities of the National Health Plan 2003-2014 [10] and the National Health Programme 2007-2015 [11]. It was confirmed that a change in the level of TC, LDL and HDL cholesterols decreases the risk of death by cardiovascular diseases to a high degree [12] [13] [14] [15]. The level of TC in the serum is a component of the SCORE (European Systematic Coronary Risk Evaluation) algorithm used in the Prophylaxis and Early Detection of Cardiovascular Diseases Programme, which aims at assessing the risk of death resulting from cardiovascular diseases. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction The aim of this study was to evaluate changes in the levels of certain lipids in a group of participants in the Prophylaxis and Early Detection of Cardiovascular Diseases Programme and also to determine factors contributing to positive changes in the variables. Materials and methods The study was conducted in Zgierz, a town in central Poland. 458 people, former participants of the Prophylaxis and Early Detection of Cardiovascular Diseases Programme, were included in the study. The study tool was a questionnaire. The authors made laboratory tests to determine the lipid profile and serum glucose. They also took arterial pressure twice and made anthropometric measurements. The authors used single-factor logistic regression to evaluate the obtained results. They adopted statistical significance level of p<0.05. The data were presented as odds ratios (OR) with 95% confidence intervals (CIs). Results A positive change in TC levels was observed in 64% of the respondents, LDL cholesterol level in 47.8% and HDL cholesterol level in 60.7%. In 46.5% of the respondents, a decrease in the level of triglycerides was observed. Conclusions There is a need to initiate prophylactic activities, especially among males, people who are less educated and also among older people.
    Full-text · Article · Oct 2014 · Central European Journal of Medicine
  • Source
    • "We demonstrated statistically significant and clinically meaningful favorable trends in the population levels of the lipid measures over the last decade, finding that did not change after multivariate adjustment and elimination of lipid lowering drugs users. The desirable trends for lipid measures in our population is compatible with those of other studies using cross-sectional surveys [9-11,14] and prospective studies [13,16-18] as well. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine trends in the population levels of serum lipids among a Middle-Eastern adult population with high prevalence of dyslipidemia. A population-based cohort of adult Iranian participants, aged >=20 years underwent four consecutive examinations between 1999-2001 and 2008-2011. Trends in age and multivariate-adjusted mean lipid levels were calculated using generalized estimating equations. At each of the 4 assessments, there were significant decreases in levels of total cholesterol (TC) (multivariate-adjusted means, 5.21 vs. 4.88 mmol/L in men; 5.42 vs. 5.07 mmol/L in women), triglycerides (TGs) (2.11 vs. 1.94 mmol/L in men; 1.88 vs. 1.74 mmol/L in women), and an increase in HDL-C level in both genders (0.95 vs. 1.058 mmol/L in men; 1.103 vs. 1.246 mmol/L in women) in multivariate analyses (all Ps <0.001); however, body mass index (BMI) significantly increased simultaneously (25.92 vs. 27.45 kg/m2 in men; 27.76 vs. 30.02 kg/m2 in women) (P < 0.001). There were significant (P < 0.001) increases in fasting plasma glucose (FPG) levels only among men (5.35 vs. 5.73 mmol/L). Results did not change after excluding participants that had cardiovascular disease or used lipid lowering drugs during follow-up. There were significant decreases in the prevalence of hypercholesterolemia, low HDL-C, hypertriglyceridemia (all Ps <0.001) during follow-up. Furthermore, the consumption of lipid lowering drugs significantly increased (P <0.001). During a 10 years follow-up, favorable trends were observed in the population levels of TC, triglycerides, HDL-C, which could not be fully accounted for by the increase observed in the consumption of lipid lowering drugs. These favorable trends were counterbalanced by the progressive increase in general obesity and FPG level.
    Full-text · Article · Jan 2014 · Lipids in Health and Disease
  • Source
    • "Because pre-injury TC values were not available, Expected TC served as a relative reference for the postinjury TC values. Sources for Expected TC emanated from the Centers for Disease Control and Prevention using 2003-2006 data (GOOGLE search: "Health, United States, 2009"; see table 69) and Arnett's study [14] using 2000-2002 data. Fractional TC is the 48-hour TC value divided by the Expected TC value. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Post-traumatic ventilator-associated pneumonia (VAP) is a substantial clinical problem that increases hospital costs and typically adds to the duration of mechanical ventilation. We evaluated the impact of VAP on ventilator days. We also assessed 48-hour total blood cholesterol (TC) and other potential risk factors for the development of VAP. We performed a retrospective study of consecutive trauma patients requiring emergency tracheal intubation and evaluated TC, age, gender, ethanol status, smoker status, injury mechanism, chest injury, brain injury, Injury Severity Score (ISS), shock, day-one hypoxemia, and RBC transfusion as potential risks for VAP. The 152 patients had ISS 28.1, brain injury 68.4%, VAP 50.0%, ventilator days 14.3, and death 9.9%. Ventilator days were increased with late VAP (p < 0.0001). TC was 110.7 mg/dL with expected TC 197.5 mg/dL. TC was lower with chest injury, shock, and RBC transfusion but, higher with brain injury (p ≤ 0.01). TC decreased as ISS increased (p = 0.01). However, one patient subset (ISS ≥ 20-&-TC ≥ 90 mg/dL) had a relative increase in TC despite an increase in ISS. ISS ≥ 20-&-TC ≥ 90 mg/dL, but not ISS alone, was the only independent predictor of late VAP (OR 3.0; p = 0.002). ISS ≥ 20-&-TC ≥ 90 mg/dL and day-one hypoxemia were the only independent predictors for increased ventilator days (p = 0.01). ISS ≥ 20-&-TC ≥ 90 mg/dL, but not ISS alone, was the only predictor of death (OR 3.8; p = 0.03). Severe traumatic injury produced substantial hypocholesterolemia that is greater with chest injury, shock, and RBC transfusion, but less with brain injury. Total blood cholesterol tended to decrease with increasing injury severity. However, attenuated hypocholesterolemia (ISS ≥ 20-&-TC ≥ 90 mg/dL) represents a unique response that can occur with critical injury. Attenuated hypocholesterolemia signals early risk for late VAP, ventilator dependency, and death.
    Full-text · Article · Mar 2011 · Lipids in Health and Disease
Show more