Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2016

Questions for Margaret Carroll, M.S.P.H., Health Statistician and Lead Author on “Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2016”

Q: How has the prevalence of high total cholesterol and low levels of high-density lipoprotein (HDL) in U.S. changed since 1999-2000 to 2015-2016?

MC: The prevalence of high total cholesterol (>=240 mg/dL) of adults 20 years and older declined from 1999-2000 to 2015-2016; the prevalence of low high-density lipoprotein(HDL) cholesterol (<40 mg/dL) declined  in adults 20 years and older from 2007-2008 to 2015-2016.  No change was seen from 2013-2014 to 2015-2016 in either high total cholesterol or low HDL cholesterol.

Q: Why is it important to study the prevalence of high total and low HDL cholesterol?

MC: High levels of total cholesterol and low levels of HDL cholesterol are risk factors for cardiovascular disease, the leading cause of death in the United States.

Also, as part of its objectives to improve the health of the U.S. population, Healthy People 2020 has included the goal of reducing the proportion of adults with high total blood cholesterol to less than 13.5%. Both men and women aged 20 and over currently meet this goal. However, not all subgroups meet this target.

Q: Was there anything in the report that surprised you?

MC: The findings did not particularly surprise me.  Based on the earliest available and comparable data from the National Health and Nutrition Examination Survey (NHANES), declining trends were observed in high total cholesterol from 1999–2000 to 2015–2016 and in low HDL cholesterol from 2007–2008 to 2015–2016. However, the observed change for high total and low HDL cholesterol from 2013–2014 to 2015–2016 was not statistically significant.

Q: How does the prevalence of high total and low HDL cholesterol breakdown by age and gender in U.S.?

MC: Men ages 40-59 years have a higher prevalence of high total cholesterol than men ages 20-39 years and 60 years and older but there is no significant difference between men 20-39 years and those 60 years and older.  The prevalence of high total cholesterol is lower in women ages 20-39 years than in women 40-59 years and 60 years and older but there is no significant difference between women 40-59 years and 60 years and older.

Men ages 40-59 years have a higher prevalence of low HDL cholesterol than men 60 years and older.  A declining trend in the prevalence of low HDL cholesterol was seen in women from 20-39 years and 60 years and older.

Q: What is the take-home message from this report? 

MC: High total cholesterol has declined in adults 20 years from 1999-2000 to 2015-2016 and low HDL cholesterol has declined from 2007-2008 to 2015-2016.