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NEW YORK (Reuters Health) - The decline in total
cholesterol levels in the U.S. seems to have slowed almost to a halt,
showing little change in more than a decade despite public awareness
campaigns to reduce cholesterol, officials at the Centers for Disease
Control and Prevention (CDC) announced this week. In a 1999-2000 survey,
the average cholesterol level among U.S. adults was 203 milligrams
per deciliter of blood (mg/dL). This represents only a two-mg/dL drop
from a previous national survey.
Currently, the American Heart Association (AHA) advises keeping total
cholesterol levels below 200 mg/dL. Levels from 200 mg/dL to 239 mg/dL
are considered borderline high, while total cholesterol of 240 mg/dL
and above is considered high. The new findings suggests that "renewed
efforts are necessary to lower total cholesterol concentrations in
the U.S. population," writes a team led by Dr. Earl S. Ford at the
CDC. People with high cholesterol are at increased risk of heart disease,
the leading cause of death in the U.S. More than 500,000 Americans
die of heart disease each year. Other risk factors include smoking,
excess weight, a sedentary lifestyle and type 2 diabetes. The findings,
published online this week by the AHA journal Circulation, are based
on cholesterol levels of about 4,000 men and women who were participating
in the National Health and Nutrition Examination Survey from 1999
to 2000. Their cholesterol levels were compared with national data
collected from more than 15,000 people during a similar survey conducted
between 1988 and 1994. For all adults, the age-adjusted average total
cholesterol concentration decreased from 205 mg/dL to 203 mg/dL between
the two surveys, the authors report. By comparison, cholesterol levels
dropped by eight mg/dL between a 1976-1980 survey and the 1988-1994
survey. The investigators also found that only about 70 percent of
Americans with total cholesterol of at least 200 mg/dL have had their
cholesterol checked -- a simple blood test conducted at a doctor's
office. Just 35 percent of people with total cholesterol of at least
200 mg/dL said they were aware their cholesterol level was higher
than recommended. Just 12 percent of people with total cholesterol
over 200 mg/dL were currently on cholesterol-lowering treatment. Aside
from the fact that the drop in cholesterol levels has slowed nearly
to a halt, the low levels of control over high cholesterol is cause
for concern, the authors report. "The slow-down in getting cholesterol
to healthy levels is concerning," Ford said in a statement. "Even
more alarming is our finding that younger participants, women and
Mexican American men had the lowest rates of cholesterol control,"
he added. Ford and his colleagues are not sure how to explain the
slowed trend in declining cholesterol levels. Possibilities include
reduced physical activity, poorer dietary habits and the rising level
of obesity in the U.S. The soluble fiber found in cereal grains, beans,
peas, legumes, and fruits and vegetables may help to lower cholesterol
levels, and exercising and maintaining a healthy weight have been
shown to reduce "bad" LDL cholesterol and boost "good" HDL cholesterol.
SOURCE: Circulation: Journal of the American Heart Association 2003;107.
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