Sempos C T, Cleeman J I, Carroll M D, Johnson C L, Bachorik P S, Gordon D J, Burt V L, Briefel R R, Brown C D, Lippel K
Division of Health Examination Statistics, Centers for Disease Control and Prevention, Hyattsville, Md.
JAMA. 1993 Jun 16;269(23):3009-14. doi: 10.1001/jama.269.23.3009.
To estimate the current levels and trends in the proportion of US adults with high blood cholesterol based on guidelines from the second report of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP II).
Nationally representative cross-sectional surveys.
SETTING/PARTICIPANTS: Data for 7775 participants 20 years of age and older from phase 1 of the third National Health and Nutrition Examination Survey (NHANES III) (data collected from 1988 through 1991) and for 9797 participants 20 through 74 years of age from NHANES II (data collected from 1976 through 1980) were used.
From the data collection period in NHANES II (1976 through 1980) to the period in NHANES III (1988 through 1991), the proportion of adults with high blood cholesterol levels (> or = 240 mg/dL [6.21 mmol bd) fell from 26% to 20%, while the proportion with desirable levels (< 200 mg/dL [5.17 mmol/L]) rose from 44% to 49%. Currently, using the ATP II guidelines and NHANES III data, 40% of all adults 20 years of age and older would require fasting lipoprotein analysis; and 29% of all adults would be candidates for dietary therapy (as compared with 36%, using NHANES II data). Based on 1990 population data, it is estimated that approximately 52 million Americans 20 years of age and older would be candidates for dietary therapy. Assuming that dietary intervention would reduce low-density lipoprotein (LDL) cholesterol levels by 10%, as many as 7% of all adult Americans (approximately 12.7 million) might be candidates for cholesterol-lowering drugs. This estimate reflects approximately 4 million adults with established coronary heart disease, of whom half are aged 65 years and older, and up to 8.7 million adults without established coronary heart disease, of whom up to 3.1 million are aged 65 years and older.
Substantial progress has been made in reducing the prevalence of high blood cholesterol; yet a large proportion of all adults, approximately 29%, require dietary intervention for high blood cholesterol.
根据美国国家胆固醇教育计划（NCEP）成人治疗专家组第二次报告（ATP II）的指南，评估美国成年人高血胆固醇的当前水平及变化趋势。
具有全国代表性的横断面调查。
设置/参与者：使用了第三次全国健康与营养检查调查（NHANES III）第一阶段中7775名20岁及以上参与者的数据（数据收集时间为1988年至1991年），以及NHANES II中9797名20至74岁参与者的数据（数据收集时间为1976年至1980年）。
从NHANES II的数据收集期（1976年至1980年）到NHANES III的数据收集期（1988年至1991年），高血胆固醇水平（≥240mg/dL[6.21mmol/L]）的成年人比例从26%降至20%，而理想水平（<200mg/dL[5.17mmol/L]）的成年人比例从44%升至49%。目前，根据ATP II指南和NHANES III数据，所有20岁及以上成年人中有40%需要进行空腹脂蛋白分析；所有成年人中有29%符合饮食治疗条件（相比之下，使用NHANES II数据时这一比例为36%）。根据1990年的人口数据，估计约有5200万20岁及以上的美国人符合饮食治疗条件。假设饮食干预可使低密度脂蛋白（LDL）胆固醇水平降低10%，那么所有成年美国人中多达7%（约1270万）可能符合降胆固醇药物治疗条件。这一估计包括约400万已确诊冠心病的成年人，其中一半年龄在65岁及以上，以及多达870万未确诊冠心病的成年人，其中多达310万年龄在65岁及以上。
在降低高血胆固醇患病率方面已取得显著进展；然而，所有成年人中仍有很大一部分（约29%）需要针对高血胆固醇进行饮食干预。
