ATLANTA — Only about half of U.S. adults with high levels of bad cholesterol get treatment for it. Worse, not all those treated are managing to control the problem, according to a new government report.
In all, as many as two out of three Americans with high levels of bad cholesterol do
not have their problem under control, the Centers for Disease Control and Prevention said Tuesday.
That means only about 23 million of the 71 million adults with worrisome bad cholesterol levels keep it in check, perhaps because many don’t eat wisely, exercise or take prescribed medications, experts said.
High cholesterol “remains out of control in this country,” said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.
Cholesterol is a waxy, fat-like substance found in many foods that can clog blood vessels. The new study focused on LDL or “bad cholesterol.” That kind accounts for most of the body’s cholesterol and is considered a contributor to strokes and heart attacks. LDL shouldn’t be over 160 for healthy people and should be below 100 for those with heart disease or diabetes.
The study included 4,300 adults from 2005-2008. Participants were counted as having too much bad cholesterol if a blood test showed high levels or they said they were on cholesterol-lowering medicine.
Overall, one in three had high levels of bad cholesterol. That proportion has been holding steady for roughly 10 years, after a previous decline. It also found high levels of bad cholesterol were most common in the elderly, and among Mexican-Americans.
Treatment rates, meanwhile, have been improving. The research showed nearly 50 percent were getting treatment, compared to about 28 percent in the years 1999-2002.
And thanks to increasing use of cholesterol medications, the proportion of people who are controlling their bad cholesterol rose from about 1 in 6 a decade ago to 1 in 3 recently, according to the CDC.
Frieden said treatment successes have also put a dent in total cholesterol levels for U.S. adults. The CDC had reported that the average total cholesterol reading has dropped to ideal levels in recent years.
It’s possible for someone to have excessive bad cholesterol but still have a good total cholesterol reading, CDC officials noted.
Treatment is much more common in people with health insurance than in the uninsured, the new study found. Nevertheless, nearly four out of five with uncontrolled high cholesterol said they had some form of health insurance.
The results are not surprising, said Dr. Valentin Fuster, head of New York City’s Mount Sinai Heart Center and a past president of the American Heart Association.
Cholesterol medications usually work well, but patients tends to become erratic in taking medication after six months to a year, especially if they feel well. And the health care system often doesn’t do enough to pay and persuade doctors and nurses to stay on top of their patients, he said.
“These people need very strict follow-up, or sooner or later things fall apart,” Fuster said.
Bad cholesterol can be lowered not only with medications, but also exercise and low-fat and high-fiber diets, health officials say.
The CDC on Tuesday also released research findings that half of Americans with high blood pressure are not currently getting treatment. That report echoes a study published last year in the Journal of the American Medical Association.
Also on Tuesday, an international health journal published a study concluding that most people with high total cholesterol are not getting the treatment they need.
The study looked at more than 79,000 adults in eight countries, including the United States, and found diagnosis and treatment varied from country to country. Diagnosis of problematic cholesterol levels was highest in the United States, and lowest in Thailand, for example. The study was published in the Bulletin of the World Health Organization.
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