Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2016

October 26, 2017

Questions for Margaret Carroll, M.S.P.H., Health Statistician and Lead Author on “Total and High-density Lipoprotein Cholesterol in Adults: United States, 2015–2016

Q: How has the prevalence of high total cholesterol and low levels of high-density lipoprotein (HDL) in U.S. changed since 1999-2000 to 2015-2016?

MC: The prevalence of high total cholesterol (>=240 mg/dL) of adults 20 years and older declined from 1999-2000 to 2015-2016; the prevalence of low high-density lipoprotein(HDL) cholesterol (<40 mg/dL) declined  in adults 20 years and older from 2007-2008 to 2015-2016.  No change was seen from 2013-2014 to 2015-2016 in either high total cholesterol or low HDL cholesterol.


Q: Why is it important to study the prevalence of high total and low HDL cholesterol?

MC: High levels of total cholesterol and low levels of HDL cholesterol are risk factors for cardiovascular disease, the leading cause of death in the United States.

Also, as part of its objectives to improve the health of the U.S. population, Healthy People 2020 has included the goal of reducing the proportion of adults with high total blood cholesterol to less than 13.5%. Both men and women aged 20 and over currently meet this goal. However, not all subgroups meet this target.


Q: Was there anything in the report that surprised you?

MC: The findings did not particularly surprise me.  Based on the earliest available and comparable data from the National Health and Nutrition Examination Survey (NHANES), declining trends were observed in high total cholesterol from 1999–2000 to 2015–2016 and in low HDL cholesterol from 2007–2008 to 2015–2016. However, the observed change for high total and low HDL cholesterol from 2013–2014 to 2015–2016 was not statistically significant.


Q: How does the prevalence of high total and low HDL cholesterol breakdown by age and gender in U.S.?

MC: Men ages 40-59 years have a higher prevalence of high total cholesterol than men ages 20-39 years and 60 years and older but there is no significant difference between men 20-39 years and those 60 years and older.  The prevalence of high total cholesterol is lower in women ages 20-39 years than in women 40-59 years and 60 years and older but there is no significant difference between women 40-59 years and 60 years and older.

Men ages 40-59 years have a higher prevalence of low HDL cholesterol than men 60 years and older.  A declining trend in the prevalence of low HDL cholesterol was seen in women from 20-39 years and 60 years and older.


Q: What is the take-home message from this report? 

MC: High total cholesterol has declined in adults 20 years from 1999-2000 to 2015-2016 and low HDL cholesterol has declined from 2007-2008 to 2015-2016.

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Stat of the Day – October 25, 2017

October 25, 2017


Hypertension Prevalence and Control Among Adults: United States, 2015-2016

October 18, 2017

Questions for Cheryl Fryar, M.S.P.H., Health Statistician and Lead Author on “Hypertension Prevalence and Control Among Adults: United States, 2015-2016

Q: What made you decide to conduct this study on hypertension prevalence and control?

CF: The primary motivation for conducting this study was to offer the public updated data on U.S. adults who have high blood pressure. Every two years new data are available for us to provide updated estimates of hypertension prevalence and control. Data were recently released for the 2015-2016 National Health and Nutrition Examination Survey, and our next step was to analyze the data and provide accessible statistical information that might guide actions to improve the health of the American people.


Q: Was there a finding in your new study that surprised you, and if so, why?

CF: The findings were pretty consistent with what’s been previously reported. The prevalence of hypertension hasn’t changed much since 1999. Among those with hypertension, controlled hypertension increased between 1999 and 2010, and then has remained stable since that time. There was an observed decrease in hypertension control since 2013-2014, but this change was not statistically significant. It is too early to tell whether or not a change in hypertension control is occurring.


Q: What do you think is the most interesting demographic finding among your new study’s findings for 2015-2016 – age, race, sex?

CF: There are a number of interesting demographic findings in this report, and we still find disparities among demographic subgroups. Hypertension prevalence was highest among non-Hispanic black men and women. Hypertension also increases with age — from 7.5% in the youngest age group 18-39, to 63.1% in the oldest age group 60 and over.

On the other hand, among adults with hypertension, about half of adults 40 and over with hypertension had controlled hypertension compared to about a third of young adults. Overall, women with hypertension had higher controlled hypertension than men with hypertension.


Q: When you identified adults with controlled hypertension in your study, was that through participants’ self-reporting that they were on medication for high blood pressure or another method? If it was self-reporting, how do you know it’s true?

CF: One of the strengths of the National Health and Nutrition Examination Survey, or NHANES, is that it combines both interviews in the home and physical examinations in mobile examination centers, including blood pressure measurement. In order to identify people with controlled hypertension, we looked at the measured blood pressure of adults who were taking medication for their hypertension. If they had a measured systolic blood pressure reading < than 140 mmHg AND a diastolic reading of <90 mmHg, then their hypertension was considered controlled.


Q: What is the take-home message from this report? 

CF: I think the take-home message of this report is that hypertension prevalence has remained unchanged since 1999 at around 29%, and that just under half of adults with hypertension have their hypertension under control. High blood pressure among U.S. adults is a persistent and prevalent concern that is a serious factor in the health and well-being of the nation. The statistics in this new report show that we have yet to meet the Heathy People 2020 Goal of 61.2% for hypertension control.


Fact or Fiction: Has the percentage of adults in the U.S. who are obese leveled off in the last several years?

October 16, 2017

Source: National Health and Nutrition Examination Survey

https://www.cdc.gov/nchs/data/databriefs/db288.pdf


Is the use of antidepressant medication more common among women than men?

September 12, 2017

Source: National Health and Nutrition Examination Survey

https://www.cdc.gov/nchs/data/databriefs/db283.pdf


Stat of the Day – July 13, 2017

July 13, 2017


AJPH Article and Podcast on Surveillance and Survey Methods

May 25, 2017

In the June issue of the American Journal of Public Health (AJPH), there is a new section called Surveillance and Survey Methods, authored by Denys Lau, PhD, Acting Director, Division of Health Care Statistics that will publish peer-reviewed articles that describe the latest designs and methodological novelties that established programs have adopted to improve data collection, analysis, and dissemination to meet public health surveillance objectives.

Surveillance and survey programs of interest range from those that gather data on major life events and disease onset and progression to those that track health care access, quality, and utilization over time.

In the inaugural issue, Ryne Paulose-Ram, NHANES’ Associate director for science and author of the feature Design Description article that provides an overview of the 2011–2018 NHANES, a flagship population survey conducted by NCHS, with an emphasis on the methodological changes made to oversample Asian Americans.

Since the 1970s, NHANES has monitored the health and nutritional status of adults and children in the United States. Beginning in 2011, NHANES began oversampling Asian Americans to obtain sufficient sample sizes to produce reliable estimates for this subpopulation. The feature article, in a clear and standardized format, describes the design and methods used in NHANES to oversample Asian Americans.

The intent of this section is to publish significant, innovative work that will advance methods in data collection, analysis, and dissemination to meet public health surveillance objectives that will better guide actions and ultimately improve population health.

There is also a podcast interview from AJPH Editor-in-Chief Alfredo Morabia with Denys Lau and Ryne Paulose-Ram regarding this new section.