national-health

By Nicole Ostrow Nov. 17 (Bloomberg) — Levels of “bad” cholesterol in the U.S. fell by one-third from 1999 to 2006 as more people took cholesterol-lowering drugs, U.S. researchers reported. The number of adults who had high levels of low-density lipoprotein, or LDL, cholesterol dropped to 21 percent in 2005 to 2006 from 32 percent in 1999 to 2000, according to a study published today in the Journal of the American Medical Association. About 13 percent of those in the study were taking cholesterol-lowering medicines such as Pfizer Inc. ’s Lipitor, the top-selling drug in 2008, and Merck & Co.’s Zocor, compared with 8 percent in the earlier period. The drop in the rates of high levels of LDL cholesterol may be a result of more people taking cholesterol-lowering medicine , eating a better diet and getting more exercise, said the study’s lead author, Elena Kuklina, in a telephone interview today. Even with that improvement, too many people have elevated levels, said Kuklina and other researchers at the Atlanta-based U.S. Centers for Disease Control and Prevention. “Even though it’s decreasing over time, we still have a high prevalence,” said Kuklina, an epidemiologist in the CDC’s division for heart disease and stroke prevention. “If we want to address this problem, we have to work in all different directions and at different levels like screening, diagnosis and treatment.” Up to Date Today’s study is the most up-to-date look at the number of Americans with high LDL cholesterol, Kuklina said. Cholesterol is a fat-like substance that occurs naturally in the body. Too much of it can stick to the walls of arteries, clogging them and increasing a person’s chance of developing heart disease, according to the American Heart Association. Cholesterol includes LDL and “good” or high-density lipoprotein, HDL, which in high levels may protect against heart attacks. High levels of LDL cholesterol can cause plaque to form in the arteries of the heart and brain, which may result in a heart attack or a stroke, according to the heart association. Medicines that regulate cholesterol levels generated $33.8 billion in 2008 global sales, the second largest class of drugs behind cancer treatments, which had sales of $48.2 billion, according to research firm IMS Health Inc . Researchers in the study looked at how many people in the U.S. ages 20 or older had been screened for cholesterol, how many used cholesterol-lowering medicines and checked their LDL levels over four time periods using data from the National Health and Nutrition Examination Survey . The survey assesses the health status of adults and children in the U.S. and combines interviews with physical examinations. Greatest Prevalence The study found that the greatest prevalence of high LDL levels occurred in those who were considered high risk, meaning they had at least a 20 percent chance of developing heart disease within the next 10 years. In that category, high LDL levels declined to 59 percent in 2005-2006 from 69 percent in 1999-2000, the study found. Researchers also saw that among those with high LDL cholesterol levels, 36 percent had not been screened for cholesterol before participating in the survey, 25 percent had been undiagnosed and 40 percent were untreated or inadequately treated for cholesterol in 2005-2006. Among all risk groups, the proportion of people screened for high cholesterol remained less than 70 percent during the study periods, below the 80 percent target set by Healthy People 2010 , the U.S.’s national health objectives. An editorial accompanying the study called the 70 percent screening rate “disappointing.” ‘Lot of Room’ “We still have a lot of room to go identifying people who should be treated and treating them appropriately,” J. Michael Gaziano , a cardiologist at the VA Boston and at Brigham and Women’s Hospital who wrote the editorial, said today in a telephone interview. Gaziano blamed the screening rate on the complexity of guidelines that doctors use to determine when patients should be checked and treated. “I find these results alarming,” said W. Douglas Weaver , immediate past president of the American College of Cardiology, in a statement. “Although we are making great strides in cholesterol management in patients with known heart disease, this study shows that many patients who could benefit from lipid-lowering medications and changes in their lifestyle and diet are still going unrecognized, and untreated.” To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .