Abstract | BACKGROUND: STUDY DESIGN: Nationally representative cross-sectional study. SETTING & PARTICIPANTS: 4,823 adults 20 years or older from the 2007-2010 National Health and Nutrition Examination Survey. PREDICTORS: Cardiovascular risk stratification based on current US cholesterol treatment guidelines and 2 simulated scenarios in which CKD stages 3-5 or CKD stages 1-5 were considered a CHD risk equivalent. OUTCOMES & MEASUREMENTS: RESULTS: Under current guidelines, 55.1 million adults in 2010 did not achieve the target LDL cholesterol goal. Of these, 25.2 million had sufficiently elevated levels to meet recommendations for initiating lipid-lowering therapy; 12.1 million were receiving this therapy but remained above goal. When CKD stages 3-5 were considered a CHD risk equivalent, 59.2 million persons were above target LDL cholesterol goals, with 28.5 million and 13.3 million meriting therapy initiation and intensification, respectively. When CKD stages 1-5 were considered a CHD risk equivalent, 65.2 million adults were above goal, with 33.9 million and 14.4 million meriting therapy initiation and intensification, respectively. LIMITATIONS: CONCLUSIONS: Many adults in the United States currently do not meet recommended goals for LDL cholesterol levels. Modifying the current cholesterol guidelines to include CKD as a CHD risk equivalent would lead to a substantial increase in both the number of persons with levels above LDL cholesterol treatment targets and those recommended to initiate lipid-lowering therapy.
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Authors | Meredith C Foster, Andreea M Rawlings, Elizabeth Marrett, David Neff, Morgan E Grams, Bertram L Kasiske, Kerry Willis, Lesley A Inker, Josef Coresh, Elizabeth Selvin |
Journal | American journal of kidney diseases : the official journal of the National Kidney Foundation
(Am J Kidney Dis)
Vol. 63
Issue 5
Pg. 753-60
(May 2014)
ISSN: 1523-6838 [Electronic] United States |
PMID | 24369751
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2014 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved. |
Chemical References |
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Topics |
- Adult
- Aged
- Cholesterol, LDL
(blood)
- Coronary Disease
(blood, epidemiology, etiology)
- Cross-Sectional Studies
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Nutrition Surveys
(methods)
- Public Health
- Renal Insufficiency, Chronic
(classification, complications, epidemiology)
- Retrospective Studies
- Risk Assessment
- Risk Factors
- United States
(epidemiology)
- Young Adult
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