Inadequate Lipid Target Achievement among US Treated Adults with Dyslipidemia

Background: Despite available medications for dyslipidemia, many treated persons still have suboptimal lipid levels. We examined the extent of residual dyslipidemia in U.S. adults. Methods: We studied a sample of 2679 U.S. adults aged 18 and over from the National Health and Nutrition Examination Survey 2007-2008, of which 1473 (55%) were defined to have dyslipidemia, based on modified 2004 National Cholesterol Education Program - Adult Treatment Panel III Update and 2006 American Heart Association/American College of Cardiology cutpoints for LDL-C along with the Framingham risk score for cardiovascular disease or if on pharmacologic treatment. Of these, 669 (45.4%) were on pharmacologic treatment. Among this group, we examined the proportions of individuals who still had LDL-C not at goal, low HDL-C, and/or elevated triglycerides.Results were projected to represent the U.S. adult population in millions. Results: In this cohort treated for dyslipidemia, mean (SD) age was 61.2 (12.1) years, and 49.8% were male. Over half (55.0%) were of non-Hispanic white, 24.8% Hispanic and 16.1% African American race. Only 17.6% of subjects on treatment for dyslipidemia were at recommended levels for all three lipids (LDL-C, HDL-C, and triglycerides). LDL-C remained above goal for 63% of subjects, 28% had low HDL-C, and 42% had elevated triglycerides. Two lipid abnormalities were identified in 27.5% of subjects and 12% had all three lipid parameters not at recommended levels (figure). Conclusion: Despite widely available treatments for dyslipidemia, many persons remain not at LDL-C goal and/or at recommended levels for other lipids, indicating opportunities for more intensive combination lipid-lowering treatment and efforts to improve adherence.