title: Cholesterol screening for women: who is "at-risk"?
abstract: BACKGROUND
  High cholesterol often precedes cardiovascular disease (CVD) and guidelines recommend cholesterol screening among at-risk women. Definitions of CVD risk vary and prevalence of dyslipidemia (abnormal total cholesterol, high-density lipoprotein (HDL-C), or non-HDL-C) among at-risk women may vary by age and definition of CVD risk.
  
  
  METHODS
  This study used 2007-2008 National Health and Nutrition Examination Survey data (n=1,781), a representative sample of the U.S. civilian, non-institutionalized population, to estimate the proportion of women without previous dyslipidemia diagnosis who are U.S. Preventive Services Task Force (USPSTF) at-risk and American Heart Association (AHA) at-risk. We also report dyslipidemia prevalence stratified by age.
  
  
  RESULTS
  Over half (55.0%) of younger women (20-44 years) and 74.2% of older women (≥45 years) were USPSTF at-risk, while nearly all younger and older women had at least one AHA risk factor (99.5% and 99.6%, respectively). Dyslipidemia prevalence among younger women was 47.3% (95% confidence interval [CI]: 42.2-52.5) for USPSTF-at-risk and 39.5% (95% CI: 35.7-43.4) for AHA at-risk. Among older women, it was 65.5% (95% CI: 60.8-69.9) for USPSTF at-risk and 63.3% (95% CI: 59.0-67.4) for AHA at-risk.
  
  
  CONCLUSIONS
  The AHA risk definition identified 45% more young women and 25% more older women than the USPSTF risk definition; however, both definitions of at-risk identified similar prevalence estimates of dyslipidemia among women. Given a high prevalence of dyslipidemia among younger women, future research is needed to assess whether identification and treatment of young women with dyslipidemia will decrease CVD mortality among them later in life.
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. ggf9@cdc.gov
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Robbins
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Dietz
authors.forename: Shanna
authors.initials: S
authors.lastname: Cox
authors.forename: Elena V
authors.initials: EV
authors.lastname: Kuklina
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000517:prevention & control; D002784:Cholesterol / Q000097:blood*; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009749:Nutrition Surveys; D011314:Preventive Health Services; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D016387:Women's Health; D055815:Young Adult
chemical_list: D002784:Cholesterol