Abstract 3703: Trends in Lipid Fractions and Antidyslipidemic Use among US Adults: Findings from the National Health and Nutrition Examination Survey II, III, and 1999–2006
Objective To examine changes in lipid fractions among US adults and the proportion of antidyslipidemic use during the past three decades.
Methods Adults aged 20 to 74 years who took the blood lipid examination were selected from various waves of the National Health and Nutrition Examination Surveys (NHANES): NHANES II (1976 –1980), NHANES III (1988 –1994), and NHANES 1999 –2006. Age-adjusted mean total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were compared among waves using direct estimate method. The proportion of self-reported antidyslipidemic use, stratified by age, was also examined.
Results For all adults, the age-adjusted mean TC decreased from 209.58 mg/dL in NHANES II to 200.05 mg/dL (p< .001) in NHANES 1999 –2006, with 12.81 mg/dL decrease among men and 6.5 mg/dL among women. LDL-C was assessed by actual and/or two commonly used estimation methods, which showed a similar pattern over time with a decreased value of 16 mg/dL (p< .001). Increased mean HDL-C was observed for men (1.06 mg/dL) and women (2.64 mg/dL), both of which may be a result of increased means within the elderly population (p< .001). The mean TG showed a continued increase in older adults; however, for other age groups, it decreased from NHANES II to NHANES III and then greatly increased from NHANES III to NHANES 1999 –2006. With available data, use of antidyslipidemics was less than 2.6% among US adults with abnormal lipid fractions. The prescription use increased with age in 1988 –1994, but showed that more than 50% of users were adults aged 40 –59 years in 1999 –2004.
Conclusions TC and LDL-C have continually decreased among US adults between NHANES II and NHANES 1999 –2006. The increase in use of antidyslipidemics over the past 30 years is likely a major factor in the downward trends of these lipid parameters. HDL-C has increased among US adults during the same period, although it is not clear what may be affecting this change. Considering the increase in mean TG from 1988 to 2006, this study suggests that irrespective of gains made in controlling some lipid fractions, TG are a growing problem.