Epidemiology of Hyperlipidemia in the U.S.

A new study of prevalence and management of hyperlipidemia has stimulated provocative suggestions for new treatment approaches, particularly in patients at high coronary risk. Researchers used data from four National Health and Nutrition Examination Surveys (NHANES) to assess low-density lipoprotein cholesterol (LDL-C) levels and treatment in about 7000 adults from 1999 through 2006. Coronary heart disease risks were classified as high (known CHD, diabetes mellitus, or 10-year Framingham risk score >20%), intermediate (≥2 major risk factors but 10-year risk ≤20%), or low (no or 1 major CHD risk factor). The authors defined high LDL-C as ≥100 mg/dL for high-risk people, ≥130 for intermediate-risk people, and ≥160 for low-risk people.

Participant-reported screening rates remained constant at about 64% throughout the 8 years. Among participants with elevated LDL-C levels, 35% were unscreened, 25% had been screened but not told the results, and 40% had been screened but treated inadequately. The overall prevalence of high LDL-C levels declined from 32% to 21% during the study period. People at high risk were most likely to exhibit high LDL-C levels, although the prevalence dropped from 69% to 59% in this group during the study period. In high-risk participants with elevated LDL-C levels, roughly two thirds of those eligible for medication did not receive treatment.