Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2018

Questions for Margaret Carroll, Health Statistician and Lead Author of “Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2018.”

Q: How has the prevalence of high total cholesterol among US adults changed since 1999-2000 data and and low high-density lipoprotein cholesterol (HDL-C) since 2007-2008?

MC: There has been a declining trend in the prevalence of high total cholesterol since 1999-2000 and a declining trend in the prevalence of low HDL-C since 2007-2008.

Q: Can you summarize how the data varied by sex, age groups and race?

MC: The prevalence of high total cholesterol:

• Higher in adults aged 40-59 than in adults aged 20-39 and those aged 60 and over
• Not significantly different between men and women aged 20 and older
• Not significantly different among non-Hispanic white, non-Hispanic black, non-Hispanic Asians and Hispanics

The prevalence of low HDL-C:

• Higher in men than in women overall, within each age group and within each race and Hispanic origin group.
• lower among NH black adults than in non-Hispanic white adults, non-Hispanic Asian adults and Hispanic adults over all and in men.
• Higher among Hispanic adults than among non-Hispanic white, non-Hispanic black and non-Hispanic Asian adults overall, among men and among women.

Q: Was there a specific finding in the data that surprised you from this report?

MC: Although we weren’t surprised because the results have been seen in the past, men continue to have a much higher prevalence of low HDL-C compared to women.

Q: How did you obtain this data for this report?

MC: Results presented in this report are based on data from the National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross sectional, probability survey representative of the United States non-institutionalized population.  Beginning in 1999 NHANES became a continuous survey and data have been released in 2-year cycles.  Data from 2015-2016 and 2017-2018 were used to test differences in the prevalence of high total and low HDL-C cholesterol between subgroups. Trends in the prevalence of high total cholesterol are based on data from ten 2-year cycles from 1999-2000 through 2017-2018. Trends in the prevalence of low HDL-C are based on six 2-year cycles from 2007-2008 through 2017-2018

Q: What is the take home message for this report?

MC: Over 1 in ten (11%) adults have high total cholesterol and over 17% have low HDL-C. The prevalence of high total cholesterol has declined since 1999-2000; the prevalence of low HDL-C has declined since 2007-2008.