Abstract P397: Twenty-year Trends of Treatment and Control for Elevated Serum Cholesterol among Minnesota and U.S. Adults

Abstract

Background: We recently reported lower CHD mortality rates and risk factor levels between 1980 and 2000 in Minnesotans compared to the general US population. Here we report the trends for treatment and control of elevated serum total cholesterol (TC). Methods: Cross-sectional surveys were conducted in men and women aged 25-74 years in the Minnesota Heart Survey (MHS) from 1990 to 2009 and in the National Health and Nutrition Examination survey (NH) from 1988 to 2008, in which height, weight, and medication use were obtained and TC measured. A single generalized linear mixed model was used to estimate age-adjusted and gender-specific linear trends of TC and of treatment and control of high TC in MHS and NH taking into account the complex sampling strategy as random effects, (i.e., neighborhood or strata and primary sampling unit pairings). Differences (pdiff) were calculated for slope and TC between surveys. Results: Between 1990 and 2008-09, percent obese increased. TC declined at the same rate in MHS and NH men and women, but TC levels were lower in MHS (pdiff0.05). TC was generally lower in MHS men and women compared to NH for each treatment and control category. Conclusion: Although TC levels have declined over the past several decades in both regional and national populations, the prevalence for untreated and treated but uncontrolled high TC remains high at 38% in MHS and 46% in NH. Findings were more favorable for Minnesotans than nationally. 20-Year Trends of Serum Cholesterol Treatment and Control in Men and Women: MHS vs. NHANES Untreated/ Controlled (%) Untreated/ Uncontrolled (%) Treated/ Controlled (%) Treated/ Uncontrolled (%) Year * MHS NH MHS NH MHS NH MHS NH Men 1991 41.9 40.7 35.4 36.9 6.0 3.8 16.8 18.5 1996 ** 39.1 38.3 36.0 35.7 6.3 8.1 18.6 17.8 2001 38.4 40.3 31.4 31.9 12.2 8.8 18.0 19.0 2008 40.6 39.1 21.2 30.7 22.0 16.3 16.1 13.9 Ptrend 0.32 0.36 <=0.001 0.001 <0.001 <0.001 0.56 0.03 Pdiff p=0.90 p=0.001 p=0.005 p=0.20 Women 1991 48.7 42.9 30.1 34.8 4.2 3.4 17.0 18.9 1996 45.9 39.3 30.7 34.3 5.9 5.6 17.5 20.8 2001 47.0 43.9 27.7 32.8 6.8 5.9 18.4 17.5 2008 48.1 40.9 23.9 27.9 12.8 12.7 15.2 18.5 ptrend 0.86 0.25 <0.001 <0.001 <0.001 <0.001 0.21 0.73 pdiff p=0.45 p=0.86 p=0.91 p=0.52 Controlled total cholesterol=less than 200 mg/dL, Uncontrolled total cholesterol= greater than or equal to 200 mg/dL MHS=Minnesota Heart survey; NH=NHANES * Midpoint of survey time period ** Survey year for NHANES was 1999