PREVALENCE OF HIGH BLOOD CHOLESTEROL AMONG UNITED-STATES ADULTS - AN UPDATE BASED ON GUIDELINES FROM THE 2ND REPORT OF THE NATIONAL-CHOLESTEROL-EDUCATION-PROGRAM ADULT TREATMENT PANEL

Objective.-To estimate the current levels and trends in the proportion of US adults with high blood cholesterol based on guidelines from the second report of the National Cholesterol Education Program (NCEP) Ad ult Treatment Panel (ATP II). Design.-Nationally representative cross- sectional surveys. Setting/Participants.-Data for 7775 participants 20 years of age and older from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III) (data collected from 1988 th rough 1991) and for 9797 participants 20 through 74 years of age from NHANES II (data collected from 1976 through 1980) were used. Results.- From the data collection period in NHANES II (1976 through 1980) to th e period in NHANES III (1988 through 1991), the proportion of adults w ith high blood cholesterol levels (greater-than-or-equal-to 240 mg/dL [6.21 mmol/L]) fell from 26% to 20%, while the proportion with desirab le levels (<200 mg/dL [5.17 mmol/L]) rose f rom 44% to 49%. Currently, using the ATP II guidelines and NHANES III data, 40% of all adults 20 years of age and older would require fasting lipoprotein analysis; an d 29% of all adults would be candidates for dietary therapy (as compar ed with 36%, using NHANES II data). Based on 1990 population data, it is estimated that approximately 52 million Americans 20 years of age a nd older would be candidates for dietary therapy. Assuming that dietar y intervention would reduce low-density lipoprotein (LDL) cholesterol levels by 10%, as many as 7% of all adult Americans (approximately 12. 7 million) might be candidates for cholesterol-lowering drugs. This es timate reflects approximately 4 million adults with established corona ry heart disease, of whom half are aged 65 years and older, and up to 8.7 million adults without established coronary heart disease, of whom up to 3.1 million are aged 65 years and older. Conclusions.-Substanti al progress has been made in reducing the prevalence of high blood cho lesterol; yet a large proportion of all adults, approximately 29%, req uire dietary intervention for high blood cholesterol.