Abstract 17156: No Major Change in Low-density Lipoprotein Cholesterol Goal Attainment in the United States From 2003 to 2012: A Time-sensitivity Analysis Using National Health and Nutrition Examination Survey Data
Introduction: Although use of lipid-lowering therapies (LLT) for treatment of dyslipidemia is increasing, there is little evidence that this has increased the percentage of patients achieving LDL-C goals of <100 mg/dL, <130 mg/dL, and <160 mg/dL for adults at high, intermediate, and low CHD risk, respectively (based on NCEP ATP III). We used reported LDL-C levels in the National Health and Nutrition Examination Survey (NHANES) to estimate proportion of the US adult population meeting LDL-C goals as a function of time (2003-2012).
Methods: Coronary heart disease risk using NCEP ATP III criteria was assessed in adult participants in 2-yearly NHANES surveys from 2003-2004 to 2011-2012. The proportion of each risk group meeting LDL-C goals and the proportion receiving LLT were calculated.
Results: Estimates for the US population were based on 11,256 observations from NHANES (2003-2012). No obvious change over time was observed in the distribution of risk, with 66%, 17%, and 17% of the population estimated to be at low, intermediate and high risk in 2003-2004 and 67%, 14%, and 19%, respectively, in 2011-2012. From 2003-2012, a statistically significant increase in the use of LLT was observed in low- (p<0.0001) and high-risk (p=0.008) groups (Figure). Although there was an increase in proportion of patients in the intermediate- and high-risk categories achieving LDL-C goals between 2003-2004 and 2005-2006, there was no significant improvement in LDL-C goal attainment in low- (p=0.89), intermediate- (p=0.41) or high-risk (p=0.09) groups over the entire period (Figure).
Conclusion: Despite increased use of LLT, we observed no trend for improvement in LDL-C goal attainment in adults in the US population. Approximately 69 million adults (33% of the population) are at high or intermediate CHD risk, and many are not at their LDL-C goal, highlighting the need for more aggressive identification and treatment of patients at risk, objectives articulated by the ACC/AHA guideline.
Author Disclosures: P.P. Toth: Speakers Bureau; Modest; Genzyme. Speakers Bureau; Significant; Amarin, AstraZeneca, GSK, Kowa, Merck and Co.. Consultant/Advisory Board; Modest; Amgen, AstraZeneca, Merck and Co, Novartis, Sanofi, Regeneron. Consultant/Advisory Board; Significant; Kowa. M.K. Palmer: Other; Modest; AstraZeneca. K.M. Henriksson: Employment; Significant; AstraZeneca.
- © 2015 by American Heart Association, Inc.