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October 30, 2017

Why are high cholesterol rates falling? Experts are stumped.

Daily Briefing

    The prevalence of high total cholesterol among U.S. adults declined substantially from 1999-2000 to 2015-2016—reaching a U.S. public health goal, according to a CDC data brief released Thursday.

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    For the data brief, CDC researchers analyzed data on high total cholesterol and low high-density lipoprotein (HDL) cholesterol, also known as good cholesterol, from National Health and Nutrition Examination Surveys (NHANES) spanning 1999–2000 through 2015–2016. Margaret Carroll, the data brief's lead author, said CDC plans to release data on levels of low-density lipoprotein (LDL) cholesterol, also known as bad cholesterol, at a later date.

    The researchers defined high cholesterol as being above 240 mg/dl in the blood.


    The researchers found that the prevalence of high total cholesterol among U.S. adults ages 20 and older fell from 18.3 percent in 1999-2000 to 12.4 percent in 2015-2016—falling below Healthy People 2020's goal of reducing the share of U.S. adults with high total cholesterol to less than 13.5 percent.

    According to the data, the prevalence of high total cholesterol was highest among adults ages 40 to 59, at 17.1 percent. In comparison, the prevalence of high total cholesterol was 7.9 percent among adults ages 20 to 39 and 12.5 percent among adults ages 60 and older.

    By gender, the study found men ages 40 to 59 had higher rates of high total cholesterol, at 16.5 percent, than those ages 20 to 39 and those 60 and over, whose rates were 9.1 percent and 6.9 percent, respectively. Among women, those ages 20 to 39 had far lower rates of high total cholesterol at 6.7 percent than those ages 40 to 59 and those 60 and over, who both had rates above 17 percent.

    The researchers found no significant differences in high total cholesterol among men of different races and ethnicities. However, among women, the researchers found non-Hispanic white women had the highest prevalence of high total cholesterol.

    In addition, the researchers found that the prevalence of U.S. adults with low levels of HDL cholesterol—which helps rid bad cholesterol from the bloodstream—declined from 22.2 percent in 2007-2008 to 18.4 percent in 2015-2016. According to the data, low HDL cholesterol prevalence was higher among Hispanic adults than in non-Hispanic white, black, and Asian adults. 


    Carroll said, "It's good news that total cholesterol is going down." But health experts say it is not clear why they are declining.

    Robert Eckel, a professor of medicine at the University of Colorado and a former president of the American Heart Association, said, "It can't be because we're losing weight, because that's still going up, but it could be statin use; it could be a result of the decline in smoking; or a combination of factors." He added, "Regardless, the message here is a good one and it reflects other things we're seeing, like the number of heart attacks which have gone down, too."

    According to the Washington Post's "To Your Health," health experts say some other factors that could be contributing to the decline in high total cholesterol, include a growing awareness of the risks associated with high cholesterol, a rise in health-conscious diets, and a gradual phasing out of artificial trans fats in the U.S. food supply (Berkrot, Reuters, 10/26; Wan, "To Your Health," Washington Post, 10/26; CDC data brief, 10/25).

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