High blood cholesterol is a major risk factor for coronary heart disease and stroke. A total cholesterol level less than 200 milligrams per deciliter (mg/dL) signifies a lower risk for heart disease. Total cholesterol of 240 mg/dL or above is considered high. A person with this level may have more than twice the risk of heart disease as someone whose cholesterol is below 200 mg/dL.
"Our data indicate that the trend in population decreases in total cholesterol concentration seems to have markedly slowed," says Earl S. Ford, M.D., M.P.H., a medical officer in the division of adult and community health at the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion in Atlanta.
The researchers used data on 4,148 men and women from the National Health and Nutrition Examination Survey (NHANES) from 1999-2000. Participants' cholesterol levels were known or they were taking cholesterol-lowering medication. Researchers compared the results with data from 15,719 participants in a 1988-94 NHANES survey (NHANES III). NHANES is a series of cross-sectional health examination surveys of the U.S. population.
Among U.S. adults age 20 and older, total cholesterol concentration decreased by 1.7 mg/dL from 1988-94 to 1999-2000. In comparison, total cholesterol levels dropped 8 mg/dL between the 1976-1980 NHANES and the 1988-1994 surveys, Ford says.
Researchers also found that awareness and control of the condition is low among people with high cholesterol. Only 35 percent of those with high cholesterol reported being aware of their condition, while 12 percent reported being treated for it.
About half of the participants in 1999-2000 had total cholesterol in the desirable range of less than 200 mg/dL, the researchers report.
"The slow-down in getting cholesterol to healthy levels is concerning," Ford says. "Even more alarming is our finding that younger participants, women and Mexican American men had the lowest rates of cholesterol control." But, men over age 75, black men and Mexican-American women significantly reduced total cholesterol levels. However, those reductions were not enough to offset the lack of progress in the population as a whole. "The low percentage of adults with controlled high blood cholesterol suggests the need for a renewed commitment to prevent, treat and control high cholesterol," Ford says.
"Our findings are consistent with recent results from other studies. We do not know what factors have slowed the trend toward reduced cholesterol levels. Possibilities include poor nutrition and inadequate physical activity, cholesterol screening or treatment. In addition, the epidemic of obesity in the United States in recent years may have slowed the trend," he says.
Diseases of the heart remain the leading cause of death in the United States. In 2000, nearly 13 million U.S. residents were estimated to have coronary heart disease and more than 515,000 died from it according to the American Heart Association.
Co-authors are Ali H. Mokdad, Ph.D.; Wayne H. Giles, M.D.; M.S.; and George A. Mensah, M.D.
Editor's Note: The American Heart Association's Cholesterol Low Down program is a FREE program helping people understand that elevated cholesterol is a major risk factor for heart disease and stroke. Program participants receive a free cookbook among other materials. To register, visit americanheart.org/cld or call 1-800-AHA-USA1.
NR03 – 1059 (Circ/Ford)
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