Prevalence and extent of dyslipidemia and recommended lipid levels in US adults with and without cardiovascular comorbidities: the National Health and Nutrition Examination Survey 2003-2004.
BACKGROUND
Despite improvements in low-density lipoprotein cholesterol (LDL-C) levels, recent national data are limited regarding the proportion of adults at recommended lipid levels according to the presence of cardiovascular disease (CVD) and related comorbidities. We evaluated the proportion of US adults with and without these conditions at (and distance to) recommended levels of LDL-C, non-high-density lipoprotein cholesterol (non-HDL-C), HDL-C, and triglycerides.


METHODS
We analyzed data from adults aged > or =20 who had fasted for 8 or more hours (n = 2,883, weighted to a US population of 128.5 million) in the National Health and Nutrition Examination Survey 2003-2004, a nationally representative cross-sectional survey. The number of adults at National Cholesterol Education Program recommended levels for LDL-C, non-HDL-C, HDL-C, triglycerides, and combined lipids, stratified by sex, age group, ethnicity, and the presence of CVD comorbidities was determined.


RESULTS
Although 85% to 89% of persons without CVD or related comorbidities were at recommended levels for LDL-C, non-HDL-C, HDL-C, and triglycerides, only 36% to 37% of those with CVD or related comorbidities were at recommended levels for LDL-C and non-HDL-C, and only 17% were at recommended levels for all lipids. Treated persons compared with those untreated had significantly lower LDL-C (112.3 vs 156.7 mg/dL, P < .001) and non-HDL-C levels (145.9 vs 188.7 mg/dL, P < .001), but similar HDL-C (52.0 vs 50.1 mg/dL, P = .09) and triglyceride (160.1 vs 148.7 mg/dL, P = .20) levels.


CONCLUSIONS
Despite improved LDL-C levels, many adults, especially with CVD or related comorbidities, are not at recommended levels for all lipids. Improved treatment efforts to target the spectrum of dyslipidemia are needed.
Ghandehari
Heli
H
Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, CA 92697, USA.
Kamal-Bahl
Sachin
S
Wong
Nathan D
ND
D000328:Adult; D017677:Age Distribution; D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000592:standards*; D008078:Cholesterol, LDL / Q000592:standards*; D015897:Comorbidity; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors