Total and High-density Lipoprotein Cholesterol in Adults: United States, August 2021-August 2023.

Abstract

Introduction: This report presents prevalence of high total cholesterol and low high-density lipoprotein cholesterol (HDL-C) by sex and age group for adults age 20 and older from the August 2021-August 2023 National Health and Nutrition Examination Survey (NHANES). Trends in the prevalence of high total cholesterol and low HDL-C are also presented.

Methods: Data from the August 2021-August 2023 NHANES were used to estimate the prevalence of high total cholesterol (240 mg/dL or higher) and low HDL-C (less than 40 mg/dL). NHANES's complex, multistage probability sample is representative of the U.S. civilian noninstitutionalized population. The prevalence of high total cholesterol and low HDL-C were calculated using survey weights. Standard errors were estimated using Taylor series linearization, a method that accounts for the complex sample design. Differences between groups were tested using a t statistic at the p < 0.05 significance level. Linear trends for subgroups were tested using orthogonal contrast matrices, and linear and nonlinear trends over time were tested using JoinPoint software and linear regression, accounting for unequal duration and spacing of survey cycles.

Key findings: During August 2021-August 2023, the prevalence of high total cholesterol was 11.3% in adults, with no significant difference between men and women overall. The prevalence of high total cholesterol was higher in adults ages 40-59 (16.7%) than in adults ages 20-39 (6.0%) and 60 and older (11.3%). The prevalence was lower in adults ages 20-39 compared with adults 60 and older. The pattern by age was different in men than in women. The prevalence of low HDL-C in adults was 13.8%, was higher in men (21.5%) than in women (6.6%) overall, and declined with increasing age for both men and women. High total cholesterol prevalence declined from 1999-2000 to 2013-2014 and remained stable through August 2021-August 2023. Low HDL-C prevalence declined from 2007-2008 to August 2021-August 2023.