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Trends in low-density lipoprotein cholesterol goal achievement in high risk United States adults: longitudinal findings from the 1999-2008 National Health and Nutrition Examination Surveys.


ABSTRACT:

Background

Previous studies have demonstrated gaps in achievement of low-density lipoprotein-cholesterol (LDL-C) goals among U.S. individuals at high cardiovascular disease risk; however, recent studies in selected populations indicate improvements.

Objective

We sought to define the longitudinal trends in achieving LDL-C goals among high-risk United States adults from 1999-2008.

Methods

We analyzed five sequential population-based cross-sectional National Health and Nutrition Examination Surveys 1999-2008, which included 18,656 participants aged 20-79 years. We calculated rates of LDL-C goal achievement and treatment in the high-risk population.

Results

The prevalence of high-risk individuals increased from 13% to 15.5% (p?=?0.046). Achievement of LDL-C <100 mg/dL increased from 24% to 50.4% (p<0.0001) in the high-risk population with similar findings in subgroups with (27% to 64.8% p<0.0001) and without (21.8% to 43.7%, p<0.0001) coronary heart disease (CHD). Achievement of LDL-C <70 mg/dL improved from 2.4% to 17% (p<0.0001) in high-risk individuals and subgroups with (3.4% to 21.4%, p<0.0001) and without (1.7% to 14.9%, p<0.0001) CHD. The proportion with LDL-C ?130 mg/dL and not on lipid medications decreased from 29.4% to 18% (p?=?0.0002), with similar findings among CHD (25% to 11.9% p?=?0.0013) and non-CHD (35.8% to 20.8% p<0.0001) subgroups.

Conclusion

The proportions of the U.S. high-risk population achieving LDL-C <100 mg/dL and <70 mg/dL increased over the last decade. With 65% of the CHD subpopulation achieving an LDL-C <100 mg/dL in the most recent survey, U.S. LDL-C goal achievement exceeds previous reports and approximates rates achieved in highly selected patient cohorts.

SUBMITTER: Tattersall MC 

PROVIDER: S-EPMC3615020 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Trends in low-density lipoprotein cholesterol goal achievement in high risk United States adults: longitudinal findings from the 1999-2008 National Health and Nutrition Examination Surveys.

Tattersall Matthew C MC   Gangnon Ronald E RE   Karmali Kunal N KN   Cullen Michael W MW   Stein James H JH   Keevil Jon G JG  

PloS one 20130402 4


<h4>Background</h4>Previous studies have demonstrated gaps in achievement of low-density lipoprotein-cholesterol (LDL-C) goals among U.S. individuals at high cardiovascular disease risk; however, recent studies in selected populations indicate improvements.<h4>Objective</h4>We sought to define the longitudinal trends in achieving LDL-C goals among high-risk United States adults from 1999-2008.<h4>Methods</h4>We analyzed five sequential population-based cross-sectional National Health and Nutriti  ...[more]

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