Over 40 Percent of Americans With High Cholesterol Unaware They Have It
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When it comes to high cholesterol in America, there’s good news and bad news.
While the number of U.S. adults with unhealthy levels of “bad” cholesterol has been dropping, a new scientific analysis finds that over 40 percent of people with high cholesterol don’t realize they have it — and are not getting treatment to improve it.
“Although the prevalence of severely elevated LDL-C (bad cholesterol) has declined, 1 in 17 U.S. adults still have LDL-C levels of 160 to 189 mg/dL [high cholesterol] and 1 in 48 adults have LDL-C levels of 190 mg/dL or greater [extremely high],” write the study authors.
Millions Are Unaware and Untreated for High Cholesterol
For the research, published in JAMA Cardiology this month, senior study author Salim Virani, MD, and colleagues reviewed health information on about 24,000 people ages 20 and older who were included in the National Health and Nutrition Examination Survey.
Over 10 consecutive survey periods between 1999 and 2020, about 8 percent of survey participants had high cholesterol, and nearly 3 percent had extremely high cholesterol.
In translating survey data to the U.S. population as a whole, scientists calculated that high cholesterol declined from about 12 percent of adults (representing 21.5 million Americans) to about 6 percent (14 million) over roughly two decades.
The prevalence of extremely high cholesterol also fell, dropping from about 4 percent (6.6 million adults) to 2 percent (4.8 million adults) over that time period.
The research team further examined the number of participants who were not informed about their cholesterol status and not prescribed medication to treat the condition.
They found that the fraction with high cholesterol who were unaware and untreated declined from nearly 12 million adults at the starting period to just over 6 million at the end — representing over 40 percent of people with high cholesterol.
For those in the extremely high range, the number declined from 3 million to 1.4 million.
Additionally, the study indicated that gaps in treatment and awareness appear to disproportionately affect Black, Hispanic, and low-income Americans.
Bad Cholesterol Is a Life-Threatening Matter
For Joshua Knowles, MD, an associate professor of cardiovascular medicine at Stanford Health Care in California, the results show that America has made progress when it comes to cholesterol, but we have a long way to go.
“We’ve been beating a drum for a long time talking about the importance of high LDL cholesterol and increased risk of cardiovascular disease,” he says. “While we’ve made some inroads, there’s still room for improvement. Folks are still massively underdiagnosed and undertreated.”
Cholesterol is a waxy substance, and when too much is in the body, it can slowly build up in the inner walls of the arteries that feed the heart and brain. This can lead to atherosclerosis, a narrowing of the arteries, and blood clots that can result in heart attack or stroke.
RELATED: Everything You Need to Know About Cholesterol
LDL cholesterol, however, is “one of the major controllable risk factors” for these life-threatening issues, according to the American Heart Association.
Steps to help lower unhealthy cholesterol include following a healthy diet (particularly limiting the amount of saturated fat you eat), getting regular exercise, and taking a cholesterol-lowering medication such as a statin.
“Statins are largely responsible for the decreased risk of heart attack and stroke that we’ve seen over the last few decades in the United States,” says Dr. Knowles, who was not involved in the research. “We’re in a golden age of medications that can be used to treat LDL very effectively and very safely.”
Knowles further stresses the importance of being periodically screened for cholesterol — especially since high cholesterol in itself does not cause symptoms.
“While having high cholesterol doesn’t guarantee that you’ll have a heart attack, stroke, or other heart event, it dramatically increases that risk,” he says. “So it’s really critical to know your cholesterol and get treatment. If you treat it, you can reduce the risk by 80 to 90 percent in many cases.”
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