Abstract 15945: Failure of Moderately High-Risk Patients to Achieve Recommended Low-Density Lipoprotein Cholesterol Target: The National Health and Nutrition Examination Survey 2003-2010
Introduction: The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guidelines recommend a low-density lipoprotein cholesterol (LDL-C) goal of <130 mg/dL for patients in the moderately high-risk category, with an optional goal of <100 mg/dL, but the extent to which these recommendations are being implemented is unclear. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) to determine the proportion of the US population in this cardiovascular risk category not at the guideline-recommended LDL-C goal.
Methods: Fasting blood serum data from NHANES 2003-2010 were used to categorize adults ≥20 years of age at moderately high risk based on NCEP ATP III definition of coronary heart disease (CHD) risk (2+ risk factors [10-year risk 10%-20%]) by their LDL-C level. SAS 9.2 was used for cross-sectional analyses. The Taylor series expansion method was used for variance estimates.
Results: The estimate of population for the US (50 states plus the District of Columbia) was based on 5,761observations from the NHANES Complex Survey data. The sample and projected data presented in the Table show that although an estimated 10.7 million and 17.1 million adults at moderately high risk attained the recommended LDL-C goals of <100 mg/dL and <130 mg/dL, respectively, approximately 7 times as many adults (118.3 million) are not meeting the minimal target of <130 mg/dL, and approximately 11 times as many adults have LDL-C levels ≥130 mg/dL compared with those with LDL-C levels <100 mg/dL.
Conclusions: The US population for 2012 is estimated to be 314 million people. LDL-C is modifiable and is the primary target of therapy in patients with dyslipidemia. The observation that approximately 146 million adults (about 46% of the population) are at moderately high cardiovascular risk and the large majority are not at the recommended LDL-C goal points to the need for greater education about, and more targeted implementation of, guidelines.
- © 2013 by American Heart Association, Inc.