How High Is Your Cholesterol Level?

Not enough adults are getting a simple test that could save their lives, the CDC says.

Only about two-thirds of the adult population routinely have their cholesterol level checked, according to a report in the CDC's Feb. 11 edition of the Morbidity and Mortality Weekly Report (search).

Heart disease and stroke are major causes of death in the U.S. Though there are many causes that contributed to these conditions, high cholesterol is one factor that can be treated.

Cholesterol (search) is a fat-like substance found in the body and in certain foods such as meat, oils, and eggs. High cholesterol has been linked to atherosclerosis (search), or hardening of the arteries.

Routine screening can detect abnormally high levels of cholesterol, and people aged 20 and older should have their cholesterol checked at least every five years, according to the National Cholesterol Education Program (search).

Why Get Tested?

High cholesterol is defined as a total cholesterol level of 240 milligrams per deciliter (mg/dL) or higher. Total cholesterol of less than 200 mg/dL is considered desirable.

Treatment includes eating a healthy, low-fat diet, exercising and losing extra weight. Some people may also need cholesterol-lowering drugs.

But if people aren't tested, the problem goes unnoticed. Since high cholesterol is a major risk factor for heart disease and stroke, ignorance is definitely not bliss.

Long Way to Go

By the year 2010, the federal government wants 80 percent of U.S. adults to meet cholesterol-screening guidelines. Lowering the percentage of adults with high total cholesterol to 17 percent and eliminating cholesterol gaps among racial and ethnic groups are also national goals for 2010.

America must make a lot of progress to meet those standards. At the CDC's last check, only about 63 percent of adults had had their cholesterol checked in the preceding five years.

That was as of 1999-2000, says the CDC. The numbers are based on a national survey of more than 8,100 adults aged 20 or older.

Who Gets Screened and Who Doesn't

Participants were asked if they had had their cholesterol checked within the past five years and if they had ever been told by a health professional that they had high cholesterol. They also reported whether they were taking cholesterol-lowering medications.

Older people were more likely than young adults to have had their cholesterol checked within the last five years. So were women. Compared with men, women were 1.2 times as likely to have had their cholesterol checked.

Blacks were 30 percent less likely than whites to have had their cholesterol measured in the previous five years. Even fewer Mexican-Americans had been screened. They were 57 percent less likely than whites to have had their cholesterol checked.

Improvement Plateau?

The CDC counted the number of people with high cholesterol. That included people whose test results showed high cholesterol as well as those taking cholesterol-lowering drugs.

Nearly a quarter of U.S. adults — 24.6 percent — had been told by a health care professional that they had high cholesterol.

On the basis of high cholesterol test results only, about 29 million (17 percent) adults have high cholesterol. But when the statistics were compiled on the basis of either a blood test or patients' use of cholesterol-lowering medications, the percentage of people with high cholesterol was 25 percent. Not everyone with high cholesterol takes cholesterol-lowering medication.

Awareness Gap

About 63 percent of participants with high cholesterol knew about their condition before the survey. A health professional had told them about their test results or had prescribed medication.

But for the other 37 percent, the news hadn't sunk in.

Older people were more likely to be aware of their high cholesterol condition. Women, blacks, and Mexican-Americans didn't always realize that they had a cholesterol problem.

Women were more likely to have been screened than men, but only 61 percent of women were aware of their high cholesterol, compared with 65 percent of men. Among blacks with high cholesterol, barely half (54 percent) were aware of their condition, compared with about 65 percent of whites. Less than half (42 percent) of Mexican-Americans knew about their high cholesterol.

When in Doubt, Ask

More effort should be made to encourage cholesterol screening, especially among blacks, Mexican-Americans, women, and young adults, says the CDC.

Health care providers can measure your cholesterol or double-check your health records. Some doctors automatically screen for cholesterol, but it never hurts to ask.

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: CDC, Morbidity and Mortality Weekly Report, Feb. 11, 2005. WebMD Medical Reference from Healthwise: "High Cholesterol." News release, CDC.