title: Twenty-year trends in serum cholesterol, hypercholesterolemia, and cholesterol medication use: the Minnesota Heart Survey, 1980-1982 to 2000-2002.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Although hypercholesterolemia prevalence continued to fall, significant population segments still have cholesterol concentrations near or at the level of increased risk.
authors.affiliation: Department of Epidemiology, University of Alabama, Birmingham, AL, USA. arnett@uab.edu
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Russell V
authors.initials: RV
authors.lastname: Luepker
authors.forename: Henry
authors.initials: H
authors.lastname: Blackburn
authors.forename: Christopher
authors.initials: C
authors.lastname: Armstrong
authors.forename: Steven A
authors.initials: SA
authors.lastname: Claas
mesh_terms: D000328:Adult; D000367:Age Factors; D002784:Cholesterol / Q000097:blood*; D008076:Cholesterol, HDL / Q000097:blood; D016000:Cluster Analysis; D003625:Data Collection; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D002784:Cholesterol