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Average Bad Cholesterol Levels Decreased 10 Percent
in Four Years
Cholesterol levels decreased less in women than men
from 2001 through 2004
Oct. 11, 2005 – A significant and steady decline of
approximately 10 percent in average LDL (low-density lipoprotein)
cholesterol levels has been found over a four-year period in blood tests
ordered on behalf of patients under a physician's care in the U.S.,
according to Quest Diagnostics, Inc. However, the decline was slower in
women than in men.
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The average serum LDL cholesterol level declined
from 123.7 milligrams per deciliter (mg/dL) at the beginning of 2001 to
111.7 mg/dL at the end of 2004. The recommended upper limit of LDL
cholesterol for people at average risk for heart disease is 130 mg/dL,
according to the National Cholesterol Education Program (NCEP).
Lowering LDL cholesterol, also known as "bad"
cholesterol, decreases the risk of arteriosclerosis and heart attack.
The findings are contained in an LDL Cholesterol
Heart Health Report released as the first in a series of Quest
Diagnostics Health Trends, a new indicator of patient health based on
de-identified patient testing data in the nation's largest private
database of clinical test results. For the Heart Health Report, Quest
Diagnostics conducted a retrospective analysis of data from nearly 80
million LDL cholesterol results reported by its laboratories across the
U.S. from 2001 through 2004 for adult patients age 20 years and older.
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Cholesterol Levels Decline for
Older Adults, New Study Says |
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Oct. 11, 2005 - Significant and substantial declines in average
LDL (bad) cholesterol levels were observed in men 60 years or
older and women 50 years or older but not in younger adults in a
study that included blood lipid measurements taken from 6,098 to
15,719 adults in various years going back to 1960.
The authors of this study in the October 12 issue of JAMA say
that a factor that likely contributed to the decrease in total
and LDL cholesterol observed predominantly in the older age
groups is the use of cholesterol-lowering medication, primarily
statins.
"The continued decrease of total and LDL cholesterol levels in
older adults is a positive trend. Clinical trial results suggest
that a 1 percent decrease in LDL cholesterol translates into a 1
percent decrease in relative risk for coronary heart disease (CHD),"
the authors write.
"It appears that the decreases in total and LDL cholesterol may
have been influenced more by increased medication use rather
than by positive lifestyle changes. Increasing prevalence of
obesity among adults may have contributed to a blunting in the
decrease in total and LDL cholesterol levels, as reflected in
the observed trend toward increased triglyceride levels. |
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The Heart Health Report is the first assessment of
its kind to involve so many people, and it provides up-to-date
information on national LDL cholesterol trends for people who visit the
doctor. Other population-based cardiovascular disease studies rigorously
evaluate general populations ranging from 3,000 to 60,000
well-characterized study participants and are often regional or
localized in scope. Certain characteristics of the Quest Diagnostics
data, such as seasonal variation and gender differences, have been well
described in prior studies.
"The 10% decline we saw in average LDL cholesterol
levels between 2001 and 2004 is a steeper decrease than has been
reported in a published U.S. population study, and these data are very
current," said Joyce G. Schwartz, M.D., Vice President and Chief
Laboratory Officer for Quest Diagnostics. "In addition, women showed
higher average LDL cholesterol levels than men, and their results
declined less than the men's."
"The Quest Diagnostics study shows that cholesterol
is decreasing in Americans who see their doctors and have their
cholesterol measured, and this is very important for public health,"
said Frank M. Sacks, M.D., Professor of Cardiovascular Disease
Prevention at Harvard School of Public Health. "I would expect that
these patients have an improved quality of life because lower
cholesterol means fewer heart attacks and other cardiovascular events."
The decline in average LDL cholesterol levels was
observed across all age groups, but was most pronounced for tests
performed on older patients. The decrease was greatest (approximately
13%) for people aged 70 years and older and least pronounced
(approximately 7%) for the 20-to-39-year age range.
Gender Differences
The data also revealed gender differences in LDL
cholesterol levels, which declined further in men than in women over the
four-year period. The largest differences between men and women were
observed in the older age groups. Overall, from January 2001 to December
2004, average LDL cholesterol in men fell from 124.0 mg/dL to 110.9
mg/dL. In women, average LDL cholesterol declined from 123.4 mg/dL to
112.5 mg/dL during the same time period. The rate of decline was larger
in men than women, and is statistically significant.
"These data highlight a potentially important
gender gap in cardiovascular disease risk among patients with access to
medical care. The finding underscores the need to develop system
approaches to improve the application of evidence-based guidelines and
quality of care for both men and women," said Lori Mosca, M.D., M.P.H,
Ph.D., Director, Preventive Cardiology, New York- Presbyterian Hospital
and Associate Professor of Medicine at Columbia University.
"At a time when the world is looking to
evidence-based medicine to drive better outcomes, we are proud to be
able to utilize our unique clinical database to provide quantitative
insights on the health of patients," said Surya N. Mohapatra, Ph.D.,
Chairman and Chief Executive Officer, Quest Diagnostics. "Our first
Health Trends report provides a glimpse into how 'real-world medicine'
is advancing the nation's heart health and well-being. This is an
exciting undertaking and we are pleased to share our findings."
"The Quest Diagnostics' data are remarkably
consistent with more conventional studies, such as the government's
National Health and Nutrition Examination Survey (NHANES)," said Josef
Coresh, M.D., Ph.D., Professor of Epidemiology, Biostatistics & Medicine
at Johns Hopkins University. "The broad representation and large sample
size of the Quest Diagnostics population make this report unique and
gives Quest Diagnostics the ability to provide fresh data without the
longer lag time necessarily associated with research studies, such as
NHANES."
Quest Diagnostics is not providing interpretation
of the data, which has to be considered in the context of the extensive
published research in the field. Data used in the report only include
test results with the patient's age, gender, and geographic region.
"The compilation of this large amount of lipid
testing data represents an ambitious effort to assemble information that
is potentially related to the health of Americans over the past few
years of laboratory testing by Quest Diagnostics," said Peter W. F.
Wilson, M.D., Professor of Medicine at Medical University of South
Carolina and the former Director of Laboratories for the Framingham
Heart Study. "However, there are limitations of the data that affect
interpretation." The limitations include the fact that individuals or
their physicians were not identified by name; some tests have been
repeated for the same person; and the data does not include defining
characteristics such as a person's ethnicity, medications, or medical
history.
LDL cholesterol data was derived from results of
78.3 million tests ordered by physicians on their adult, predominantly
non-hospitalized patients from January 1, 2001 through December 31,
2004. LDL cholesterol results were calculated from serum measurements of
total cholesterol, HDL cholesterol and triglycerides using standardized
laboratory procedures. The company plans to utilize its extensive
database of de-identified laboratory test results to identify health
trends for other medical conditions.
About Quest Diagnostics
Quest Diagnostics claims to be the leading provider
of diagnostic testing, information and services that patients and
doctors need to make better healthcare decisions. The company offers the
broadest access to diagnostic testing services through its national
network of laboratories and patient service centers, and provides
interpretive consultation through its extensive medical and scientific
staff. Quest Diagnostics is a pioneer in developing innovative new
diagnostic tests and advanced information technology solutions that help
improve patient care. Additional company information is available at:
http://www.questdiagnostics.com.
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