TREATMENT PATTERNS AND DISTRIBUTION OF LOW-DENSITY-LIPOPROTEIN CHOLESTEROL LEVELS IN TREATMENT-ELIGIBLE UNITED-STATES ADULTS

To estimate the fraction of United States (U.S.) adults who are eligib le for treatment to reduce elevated low-density lipoprotein (LDL) chol esterol levels based on Adult Treatment Panel II (ATP Ii) guidelines a nd the percent reduction in LDL cholesterol required by those who qual ify for treatment, we analyzed data on 7,423 respondents to Phase 2 of the third National Health and Nutrition Examination Survey (NHANES II I) administered between 1991 and 1994, Approximately 28% of the U,S, a dult population aged greater than or equal to 20 years is eligible for treatment based on ATP II guidelines. Eighty-two percent of adults wi th coronary heart disease are not at their target LDL cholesterol leve l of 100 mg/dl, Of those eligible for treatment, 65% report that they receive no treatment. Overall, 40% of people who qualify for drug ther apy require an LDL cholesterol reduction of >30% to meet their ATP II treatment goal, Approximately 75% of those with coronary heart disease who qualify for drug therapy require an LDL cholesterol reduction of >30%. Although elevated LDL cholesterol levels can be treated, prevale nce rates in the U,S, adult population remain high. Several recent stu dies indicate that a considerable percentage of people treated with dr ug therapy do not reach their treatment goals, The findings in this st udy provide at least a partial explanation for why many patients recei ving therapy do not reach their treatment goals: they require a larger reduction in LDL cholesterol than many therapies can provide. (C) 199 8 by Excerpta Medico, Inc.