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Bad cholesterol declining among older Americans

CHICAGO – Despite the sharp rise in obesity in the United States, cholesterol levels in older Americans have fallen markedly over the past 40 years, mainly because of the introduction of statin drugs in the late 1980s, a government study found.

Statins – which include such widely used medicines as Lipitor, Zocor and Pravachol – can dramatically reduce levels of LDL cholesterol, the bad kind that can clog arteries and lead to heart attacks. The drop in Americans’ overall cholesterol levels resulted from a decline in LDL.

Between 1960 and 2002, average total cholesterol levels for men and women ages 20 to 74 dropped from 222 milligrams per deciliter of blood to 203, mostly because of declines in people 50 and up. Among Americans ages 60 to 74, average levels fell from 232 to 204 in men (a 12 percent decline) and from 263 to 223 in women (down 15 percent). Below 200 is considered desirable for people at average risk for heart disease.

Also, in the study’s final decade, the percentage of adults with high cholesterol – a reading of at least 240 – fell from 20 percent to 17 percent, about eight years sooner than the government’s goal of reaching the 17 percent mark by 2010.

At the same time, the portion of adults using cholesterol-lowering drugs, mostly statins, increased from 3.4 percent to 9.3 percent, with higher rates in the oldest Americans.

Senior author Clifford Johnson, a researcher with the Centers for Disease Control and Prevention, called the figures a glimmer of good news, although cholesterol levels were mostly unchanged in adults under 50.

Other government studies have shown that between 1988 and 2002, the percentage of overweight American adults climbed from 56 percent to 65 percent, while obesity rates increased from 23 percent to 30 percent. Obesity is often accompanied by high cholesterol levels, and both factors raise the risk of a heart attack or a stroke.

“A lot of people think once they’ve gone on statin drugs, they don’t need to diet and exercise anymore,” said Dr. Robert Eckel, president of the American Heart Association.

The study appears in Wednesday’s Journal of the American Medical Association. It is based on a comparison of data from periodic government health surveys.

Co-author Dr. James Cleeman, coordinator of the government’s National Cholesterol Education Program, said a slight reduction in Americans’ consumption of saturated fat probably contributed to the cholesterol declines.