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14-04-2010 | Cardiometabolic | Article

Treatment and control of hypercholesterolemia improving, but control remains poor


Free abstract

MedWire News: Awareness, treatment, and control of hypercholesterolemia improved significantly in the USA between 1999 and 2006, but general lipid control remains poor, study findings suggest.

“Hypercholesterolemia represents one of the cardinal risk factors for coronary heart disease and, consequently, its recognition, treatment, and control have received a great deal of attention,” write Earl Ford and colleagues, from the Centers for Disease Control and Prevention in Atlanta, Georgia, USA, in the International Journal of Cardiology.

Since the 1960s, average cholesterol concentrations have decreased in the USA; however, hypercholesterolemia remains a problem and several studies have shown insufficient dyslipidemia control, including in high-risk patients with coronary heart disease.

To gain a clearer understanding of trends in the management of hypercholesterolemia, Ford and team examined data from 18,053 individuals aged 20 years or over who took part in the National Health and Nutrition Examination Surveys between 1999 and 2006.

The authors report that the unadjusted prevalence of hypercholesterolemia ranged from 53.2% to 56.1% and remained stable over the study period.

There was, however, a significant increase in the percentage of individuals who had their concentration of cholesterol measured, from 68.6% to 74.8%, and a concomitant increase in the use of cholesterol-lowering treatments from 39.1% to 54.4%. Treatment improved hypercholesterolemia control rates from 47.0% to 64.3%.

When all participants with hypercholesterolemia were considered, 7.2% had a concentration of total cholesterol below 5.2 mmol/l (200 mg/dl) in 1999–2000 compared with 17.1% in 2005–2006. Significant improvements in control occurred in all groups except those aged 20–39 years.

Of note, hypercholesterolemia control rates were significantly lower in women than in men across all time periods studied, and women were significantly less likely than men to have their cholesterol checked. In addition, African Americans and Mexican Americans were less likely to have a cholesterol check or be told about their hypercholesterolemia than Whites.

The authors say that their findings of increased cholesterol checking rates and communication of hypercholesterolemia diagnosis are “encouraging” but they add that, “despite these welcome trends our analysis also points out that levels of control remain low in the general population and that significant gender and racial or ethnic disparities in some of these parameters continue to exist.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Philip Ford