Abstract 4996: Six-year Trends in Low-Density Lipoprotein Cholesterol Goal Achievement in High-Risk United States Residents: National Health and Nutrition Examination Survey, 1999 to 2004

Background : In 2001, the Adult Treatment Panel III guidelines expanded the definition of high risk by including coronary heart disease (CHD) risk equivalent conditions. Low-density lipoprotein cholesterol (LDL-C) goals for all high-risk patients were intensified to < 100 mg/dL. This study investigates the size of the high-risk U.S. population with and without CHD and the percent LDL-C goal achievement across six years. Methods : Data from three National Health and Nutrition Examination Surveys: 1999–2000, 2001–2002, and 2003–2004 were analyzed to identify U.S. residents at high risk per ATP III guidelines. The size of each survey’s high-risk cohort and percentage LDL-C goal achievement was stratified by presence of CHD or CHD risk equivalent conditions. Results : Across the three surveys, the high-risk population was 22.2, 23.8 and 28.0 million. The percentage of all high-risk individuals with LDL-C < 100 mg/dL was 22.9%, 31.5% and 32.9%. Goal achievement in those without CHD was 20.2%, 26.0% and 31.5%. In CHD patients, goal achievement increased from 27.0% (1999–2000) to 40.9% (2001–2002) but then dropped to 35.1% (2003–2004). Conclusions : Across six years from 1999 to 2004, U.S. residents at high risk increased by 26.2% (5.8 million) compared to a 5.2% (8.3 million) rise in eligible population. Improvement in LDL-C goal achievement for those without CHD was consistent across the three surveys. Those with CHD also had a robust improvement from 1999–2000 to 2001–2002. However, while a greater absolute number of those with CHD met goal in 2003–2004, the percentage was reduced. This suggests a need for renewed attention to LDL-C goal achievement in individuals with CHD. High Risk Cholesterol Goal Achievement by CHD status