The prevalence of the disorder varies depending on the definition of dyslipidaemia and the population studied. Approximately 24.7 million adults or 10% of the adult population in the US have total cholesterol levels ≥6.2 mmol/L (≥240 mg/dL).[3]Martin SS, Aday AW, Almarzooq ZI, et al. 2024 heart disease and stroke statistics: a report of US and global data from the American Heart Association. Circulation. 2024 Feb 20;149(8):e347-913.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000001209
http://www.ncbi.nlm.nih.gov/pubmed/38264914?tool=bestpractice.com
One study evaluating how lipid concentrations changed among US adults from 2007 to 2018 found improvement with mean age-adjusted total cholesterol concentrations declining from 5.1 mmol/L (197 mg/dL) to 4.9 mmol/L (189 mg/dL) across all racial and ethnic sub-groups, with the exception of non-Hispanic Asian adults.[4]Aggarwal R, Bhatt DL, Rodriguez F, et al. Trends in lipid concentrations and lipid control among US adults, 2007-2018. JAMA. 2022 Aug 23;328(8):737-45.
https://jamanetwork.com/journals/jama/fullarticle/2795529
http://www.ncbi.nlm.nih.gov/pubmed/35997731?tool=bestpractice.com
In patients with coronary heart disease (CHD), the prevalence of dyslipidaemia is as high as 80% to 88%, compared with approximately 40% to 48% in age-matched controls without coronary disease.[5]Genest JJ, Martin-Munley SS, McNamara JR, et al. Familial lipoprotein disorders in patients with premature coronary artery disease. Circulation. 1992 Jun;85(6):2025-33.
http://www.ncbi.nlm.nih.gov/pubmed/1534286?tool=bestpractice.com
The INTERHEART study on risk factors associated with myocardial infarction found that hyperlipidaemia (defined as elevated levels of apoB/apoA1 ratio) had a population attributable risk of 49%.[6]Yusuf S, Hawken S, Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):937-52.
http://www.ncbi.nlm.nih.gov/pubmed/15364185?tool=bestpractice.com
There is a strong correlation between body mass index and incidence of hypercholesterolaemia.[7]Kawada T. Body mass index is a good predictor of hypertension and hyperlipidemia in a rural Japanese population. Int J Obes Relat Metab Disord. 2002 May;26(5):725-9.
http://www.ncbi.nlm.nih.gov/pubmed/12032759?tool=bestpractice.com
A worrisome development is the increase in the rate of risk factors for CHD (including hypercholesterolaemia) in low-income countries, while risk factors for CHD have decreased in prevalence in high-income countries.[8]Pearson TA. Cardiovascular disease in developing countries: myths, realities, and opportunities. Cardiovasc Drugs Ther. 1999 Apr;13(2):95-104.
http://www.ncbi.nlm.nih.gov/pubmed/10372224?tool=bestpractice.com
[9]NCD Risk Factor Collaboration (NCD-RisC). Repositioning of the global epicentre of non-optimal cholesterol. Nature. 2020 Jun;582(7810):73-7.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7332422
http://www.ncbi.nlm.nih.gov/pubmed/32494083?tool=bestpractice.com
While previously there had been a steady decline in mortality from heart disease in the US since the early 1960s, such declines slowed and in fact reversed from 2010 onwards. This highlights the tremendous importance of the ongoing management and evaluation of cardiovascular disease.[10]Van Dyke M, Greer S, Odom E, et al. Heart disease death rates among blacks and whites aged ≥35 years - United States, 1968-2015. MMWR Surveill Summ. 2018 Mar 30;67(5):1-11.
https://www.doi.org/10.15585/mmwr.ss6705a1
http://www.ncbi.nlm.nih.gov/pubmed/29596406?tool=bestpractice.com
[11]Centers for Disease Control and Prevention. About underlying cause of death, 1999-2020 [internet publication].
https://wonder.cdc.gov/ucd-icd10.html
One study evaluating the prevalence of statin use for the primary prevention of atherosclerotic cardiovascular disease in the US found that black and Hispanic participants had significantly lower statin use than white participants.[12]Jacobs JA, Addo DK, Zheutlin AR, et al. Prevalence of statin use for primary prevention of atherosclerotic cardiovascular disease by race, ethnicity, and 10-year disease risk in the US: National Health and Nutrition Examination Surveys, 2013 to March 2020. JAMA Cardiol. 2023 May 1;8(5):443-52.
http://www.ncbi.nlm.nih.gov/pubmed/36947031?tool=bestpractice.com