After years of steady progress, declines in cardiovascular mortality appear to have stagnated since 2008 and heart disease remains the leading cause of death in the United States. Scientists attribute the pause in progress to a recent worsening of cardiovascular risk factors, including blood pressure and blood sugar control, among U.S. adults. However, little is known about trends in another major modifiable risk factor for cardiovascular disease; lipid concentrations—the amounts of several types of fats (such as cholesterol and triglycerides) in the blood that can line and clog the arteries, making the heart work harder than necessary.

In a paper published in JAMA, physician-scientists at the Smith Center for Outcomes Research at Beth Israel Deaconess Medical Center (BIDMC) assessed whether lipid concentrations and rates of lipid control changed among U.S. adults from 2007 to 2018. They also looked at whether these trends differed by sex, race, or ethnicity. The researchers observed that while mean cholesterol concentrations improved among U.S. adults overall during this time period, there were concerning variations in these trends by race and ethnicity. The team also found there was no overall change in lipid control; that is, the proportion of U.S. adults maintaining healthy cholesterol levels with treatment.

"Nationally representative estimates of lipid trends and lipid control in the U.S. population have not been recently examined by gender or race and ethnicity, particularly for Asian and Mexican American adults," said corresponding author Rishi K. Wadhera, MD, MPP, MPhil, a cardiologist at BIDMC and section head of health policy and equity at the Smith Center for Outcomes Research. "Understanding contemporary trends in lipid concentrations and control is important, given concerning changes in population-level cardiovascular mortality and persistent disparities over the past decade."

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