Trends of Lipid Concentrations, Awareness, Evaluation, and Treatment in Severe Dyslipidemia in US Adults.

ABSTRACT

OBJECTIVE: To evaluate the contemporary trends of lipid concentrations, cholesterol evaluation, hypercholesterolemia awareness, and statin use among individuals with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] level ≥190 mg/dL) between 2011 and 2020. PATIENTS AND METHODS: This serial cross-sectional analysis included nonpregnant adults ≥20 years of age from the National Health and Nutrition Examination Survey between 2011 and 2020. Age-adjusted weighted trends of LDL-C, triglycerides, cholesterol evaluation in the past 5 years, hypercholesterolemia awareness, and documented statin use among individuals with severe dyslipidemia were estimated. RESULTS: Among 24,722 participants included, the prevalence of severe dyslipidemia was 5.4% (SE 0.2%) which was stable across the study period (Ptrend=.78). Among individuals with severe dyslipidemia (mean age 55.3 [SE 0.7] years; 52.2% females; 68.8% non-Hispanic White), LDL-C (224.3 [SE 4.2] mg/dL in 2011-2012 to 224.2 [SE 4.6] mg/dL in 2017-2020; Ptrend =.83), and triglyceride (123.3 [SE 1.1] mg/dL in 2011-2012 to 101.8 [SE 1.1] mg/dL in 2017-2020; Ptrend=.13), levels remained stable from 2011 to 2020. The rates of cholesterol evaluation in the past 5 years (72.0% [SE 5.7%] in 2011-2012 to 78.0% [SE 4.8%] in 2017-2020; Ptrend=.91), hypercholesterolemia awareness (48.1% [SE 5.5%] in 2011-2012 to 51.9% [SE 5.8%] in 2017- 2020; Ptrend=.77), and documented statin use (34.7% [SE 4.5%] in 2011-2012 to 33.4% [SE 4.0%] in 2017-2020; Ptrend=.28) remained stagnant in individuals with severe dyslipidemia between 2011 and 2020. CONCLUSION: Among individuals with severe dyslipidemia, cholesterol evaluation and hypercholesterolemia awareness rates were stable at ∼75% and ∼50% in the past decade. Only ∼34% of individuals with severe dyslipidemia took statins between 2011 and 2020, which likely contributed to the stable LDL-C levels noted across the study period. Further investigations into the determinants of statin use and adherence to statins are needed.