Utilization of lipid lowering medications among adults in the United States 1999-2006.

OBJECTIVE We examined the use of lipid lowering medications and control of dyslipidemia among US adults in 1999-2006. METHODS Data were extracted from the National Health and Nutrition Examination Survey 1999-2006. RESULTS The mean low-density lipoprotein-cholesterol (LDL-C) level significantly decreased from 3.25+/-0.03 mmol/L in 1999-2002 to 3.02+/-0.02 mmol/L in 2003-2006 in men, and from 3.11+/-0.03 to 2.98+/-0.03 mmol/L in women (p<0.001). Statins and fibrates were the most commonly used medications. Among those diagnosed with hypercholesterolemia, the proportion on treatment increased from 32.4% to 38.9% (p=0.001) in the 8-year period. The proportion of participants with a history of diabetes treated with a statin increased from 20.9+/-2.2% in 1999-2002 to 37.6+/-2.5% in 2003-2006 (p<0.001). However, only 39.9% of people with diabetes and 45.4% of people with ischemic heart disease (IHD) achieved LDL-C target levels. CONCLUSIONS Between 1999 and 2006, LDL-C level decreased in US adults and use of lipid lowering medications increased. More effort is still needed to detect and treat dyslipidemia in the community, particularly in people at high cardiovascular risk.

[1]  M. Brown,et al.  Multivalent feedback regulation of HMG CoA reductase, a control mechanism coordinating isoprenoid synthesis and cell growth. , 1980, Journal of lipid research.

[2]  M. Pfeffer,et al.  AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update endorsed by the National Heart, Lung, and Blood Institute. , 2006, Journal of the American College of Cardiology.

[3]  S. Haffner,et al.  Reduced coronary events in simvastatin-treated patients with coronary heart disease and diabetes or impaired fasting glucose levels: subgroup analyses in the Scandinavian Simvastatin Survival Study. , 1999, Archives of internal medicine.

[4]  C. Packard,et al.  Effects of nicotinic acid therapy on plasma high density lipoprotein subfraction distribution and composition and on apolipoprotein A metabolism. , 1979, The Journal of clinical investigation.

[5]  Neil J Stone,et al.  Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines , 2004, Circulation.

[6]  B. Davis,et al.  Cardiovascular events and their reduction with pravastatin in diabetic and glucose-intolerant myocardial infarction survivors with average cholesterol levels: subgroup analyses in the cholesterol and recurrent events (CARE) trial. The Care Investigators. , 1998, Circulation.

[7]  Jiang He,et al.  Trends in ATP-III-defined high blood cholesterol prevalence, awareness, treatment and control among U.S. adults. , 2007, Annals of epidemiology.

[8]  B. Cheung,et al.  Meta-analysis of large randomized controlled trials to evaluate the impact of statins on cardiovascular outcomes. , 2004, British journal of clinical pharmacology.

[9]  R. Gangnon,et al.  Implications of Cardiac Risk and Low-Density Lipoprotein Cholesterol Distributions in the United States for the Diagnosis and Treatment of Dyslipidemia: Data From National Health and Nutrition Examination Survey 1999 to 2002 , 2007, Circulation.

[10]  G. Watts,et al.  Fibrates, dyslipoproteinaemia and cardiovascular disease. , 1999, Current opinion in lipidology.

[11]  N. Wong,et al.  Prevalence and extent of dyslipidemia and recommended lipid levels in US adults with and without cardiovascular comorbidities: the National Health and Nutrition Examination Survey 2003-2004. , 2008, American heart journal.

[12]  M. Pfeffer,et al.  AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic vascular disease: 2006 update: endorsed by the National Heart, Lung, and Blood Institute. , 2006, Circulation.

[13]  K. Pahan,et al.  Lipid-lowering drugs , 2006, Cellular and Molecular Life Sciences CMLS.

[14]  Terje R Pedersen,et al.  Cholesterol Lowering With Simvastatin Improves Prognosis of Diabetic Patients With Coronary Heart Disease: A subgroup analysis of the Scandinavian Simvastatin Survival Study (4S) , 1997, Diabetes Care.

[15]  V. Preedy,et al.  National Health and Nutrition Examination Survey , 2010 .

[16]  K. Reynolds,et al.  Trends in Statin Use and Low-Density Lipoprotein Cholesterol Levels Among US Adults: Impact of the 2001 National Cholesterol Education Program Guidelines , 2008, The Annals of pharmacotherapy.

[17]  D. Jacobs,et al.  Twenty-Year Trends in Serum Cholesterol, Hypercholesterolemia, and Cholesterol Medication Use: The Minnesota Heart Survey, 1980–1982 to 2000–2002 , 2005, Circulation.

[18]  R. Gangnon,et al.  National improvements in low-density lipoprotein cholesterol management of individuals at high coronary risk: National Health and Nutrition Examination Survey, 1999 to 2002. , 2008, American heart journal.

[19]  Edward J. Mills,et al.  Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. , 2008, Journal of the American College of Cardiology.

[20]  M Alan Brookhart,et al.  Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials. , 2006, Archives of internal medicine.

[21]  S. Grundy,et al.  Mevinolin stimulates receptor-mediated clearance of low density lipoprotein from plasma in familial hypercholesterolemia heterozygotes. , 1983, Transactions of the Association of American Physicians.

[22]  W. Insull.  Clinical Utility of Bile Acid Sequestrants in the Treatment of Dyslipidemia: A Scientific Review , 2006, Southern medical journal.

[23]  N. Unwin,et al.  Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel on Executive Summary of the Third Report of the National , 2009 .

[24]  P. Sorlie,et al.  Trends in serum lipids and lipoproteins of adults, 1960-2002. , 2005, JAMA.

[25]  J. Mckenney,et al.  National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) , 2002 .