title: Improving lipid profiles and increasing use of lipid-lowering therapy in England: results from a national cross-sectional survey - 2006.
abstract: OBJECTIVE
  To evaluate blood lipid levels in the adult English population in 2006 and to report change in the use and efficacy of lipid-lowering treatment since 2003 after which time the general practitioner contract introduced a 'pay-per-performance' approach.
  
  
  METHODS
  Cross-sectional surveys.
  
  
  METHODS
  Nationally representative sample of 14,142 noninstitutionalized adults (>16 years) living in England, partaking in the Health Survey for England 2006.
  
  
  METHODS
  Mean levels of total, HDL, non-HDL and total/HDL cholesterol ratio, prevalence of hypercholesterolaemia, use of lipid lowering agents and lipid levels and control rates among those on treatment.
  
  
  RESULTS
  Age-standardized mean cholesterol levels fell from 5·49 mM in men and 5·56 mM in women in 2003 to 5·26 and 5·37 mM, respectively, in 2006. In 2006, 59% of adults had a total cholesterol ≥ 5·0 mM and 11% reported lipid-lowering treatment, of whom 66% had a total cholesterol < 5·0 mM and 22% were < 4·0 mM. The majority of those with established coronary heart disease, stroke or diabetes but fewer than one quarter of those with hypertension or ≥ 20% estimated 10-year cardiovascular risk and no established CVD took lipid-lowering drugs. Lipid lowering treatment rates increased fivefold and control rates among the treated (to < 5·0 mM) more than doubled between 1998 and 2006. About one-third of those with established CVD or diabetes had cholesterol levels of < 4·0 mM.
  
  
  CONCLUSIONS
  Previously reported improvements in treatment and control rates between 1998 and 2003 continued between 2003 and 2006, with the biggest increases among those with established CVD and diabetes.
authors.affiliation: Department of Epidemiology & Public Health, University College London, London, UK. j.mindell@ucl.ac.uk
authors.forename: Jennifer
authors.initials: J
authors.lastname: Mindell
authors.forename: Maria
authors.initials: M
authors.lastname: Aresu
authors.forename: Paola
authors.initials: P
authors.lastname: Zaninotto
authors.forename: Emanuela
authors.initials: E
authors.lastname: Falaschetti
authors.forename: Neil
authors.initials: N
authors.lastname: Poulter
mesh_terms: D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D008055:Lipids; D008075:Lipoproteins, HDL