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Discordance between high non-HDL cholesterol and high LDL-cholesterol among US adults

Meredith Kilgore1, Paul Muntner2, J Michael Woolley3

  • 1Department of Health Care Organization and Policy, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, RPHB 330, Birmingham, AL 35294-0022, USA.

Journal of Clinical Lipidology
|February 18, 2014
PubMed

Insights

Significant differences exist between non-high-density lipoprotein cholesterol (non-HDL-C) and low-density lipoprotein cholesterol (LDL-C) levels in US adults. Relying on one measure may misclassify cardiovascular disease risk.

Area of Science:

  • Cardiovascular Health
  • Lipid Metabolism
  • Public Health

Background:

  • Low-density lipoprotein cholesterol (LDL-C) is the primary target for lipid-lowering therapy.
  • Non-high-density lipoprotein cholesterol (non-HDL-C) may offer a better reflection of coronary heart disease (CHD) risk.
  • The discordance between LDL-C and non-HDL-C has not been previously evaluated.

Purpose of the Study:

  • To examine the discordance between non-HDL-C and LDL-C in US adults.
  • To assess the implications of this discordance for cardiovascular disease risk classification.

Main Methods:

  • Utilized data from the National Health and Nutrition Examination Surveys (2005-2010) with 4986 participants.
  • Defined elevated non-HDL-C and LDL-C levels using the 2004 Adult Treatment Panel III guidelines.

Main Results:

  • Prevalence of high non-HDL-C was 22.7%, and high LDL-C was 24.5%.
  • 9.7% of individuals with high non-HDL-C had normal LDL-C; 15.7% with high LDL-C had normal non-HDL-C.
  • An estimated 3.9 million US adults had high non-HDL-C with normal LDL-C, while 6.8 million had high LDL-C with normal non-HDL-C.
  • Individuals with high non-HDL-C and normal LDL-C were older, more likely male, Hispanic, and had higher prevalence of impaired fasting glucose, diabetes, metabolic syndrome, and other CHD risk factors.

Conclusions:

  • Substantial discordance exists between elevated non-HDL-C and LDL-C levels in the US adult population.
  • Solely relying on LDL-C or non-HDL-C may lead to inappropriate classification of cardiovascular disease risk.
  • This highlights the importance of considering both lipid parameters for comprehensive cardiovascular risk assessment.
Abstract

Keywords:
Cholesterol screeningCoronary heart diseaseDyslipidemiaEpidemiologyPractice guidelines

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