Transitions from Ideal to Intermediate Cholesterol Levels may vary by Cholesterol Metric

Joseph C. Engeda, Katelyn M. Holliday, Shakia T. Hardy, Sujatro Chakladar, Dan Yu Lin, Gregory A. Talavera, Barbara V. Howard, Martha L. Daviglus, Amber Pirzada, Pamela J. Schreiner, Donglin Zeng, Christy L. Avery

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

To examine the ability of total cholesterol (TC), a low-density lipoprotein cholesterol (LDL-C) proxy widely used in public health initiatives, to capture important population-level shifts away from ideal and intermediate LDL-C throughout adulthood. We estimated age (≥20 years)-, race/ethnic (Caucasian, African American, and Hispanic/Latino)-, and sex- specific net transition probabilities between ideal, intermediate, and poor TC and LDL-C using National Health and Nutrition Examination Survey (2007–2014; N = 13,584) and Hispanic Community Health Study/Study of Latinos (2008–2011; N = 15,612) data in 2016 and validated and calibrated novel Markov-type models designed for cross-sectional data. At age 20, >80% of participants had ideal TC, whereas the race/ethnic- and sex-specific prevalence of ideal LDL-C ranged from 39.2%-59.6%. Net transition estimates suggested that the largest one-year net shifts away from ideal and intermediate LDL-C occurred approximately two decades earlier than peak net population shifts away from ideal and intermediate TC. Public health and clinical initiatives focused on monitoring TC in middle-adulthood may miss important shifts away from ideal and intermediate LDL-C, potentially increasing the duration, perhaps by decades, that large segments of the population are exposed to suboptimal LDL-C.

Original languageEnglish (US)
Article number2782
JournalScientific reports
Volume8
Issue number1
DOIs
StatePublished - Dec 1 2018

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