High density lipoprotein epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamed Moubarak, M.D. [2]

Overview

The association between low HDL concentration and an elevated risk of coronary heart disease (CHD) has been demonstrated in many epidemiological studies. For every 1% decrease in HDL concentration, there is a 2-3% increase in the risk of development of CHD.[1]According to the National Health and Nutrition Examination Survey in 2009–2010, 21.3% of adults aged 20 years and over had low HDL cholesterol level (less than 40 mg/dL) in the United States. Low HDL concentration was demonstrated to be higher among men than among women. Among men, the percentage of subjects with low HDL cholesterol is lower among non-Hispanic black men than non-Hispanic white or Hispanic men.[2]

Low HDL Epidemiology and Demographics

Prevalence

  • According to the National Health and Nutrition Examination Survey in 2009–2010, 21.3% of adults aged 20 years and over had low HDL cholesterol level (less than 40 mg/dL) in the United States.
  • A large survey has been set out to determine the prevalence of low HDL in 11 European countries. The study population included 8545 patients under the treatment for dyslipidemia. This treatment appeared to exert little or no effect on the prevalence of low HDL-cholesterol, which was slightly higher than that measured in the overall population. Low HDL-cholesterol was present in 33% of men and 40% of women, with very low HDL-cholesterol present in 14% (both genders combined). The prevalence was found much higher in diabetic patients compared to general population. [3]

Gender

  • The percentage of adults with low HDL cholesterol as shown below was higher for men (31.4%) than for women (11.9%). Percentages among men were also higher than those among women of the same racial and ethnic group.[2]

Race

  • For men, the percentage with low HDL cholesterol was lower among non-Hispanic black men than non-Hispanic white or Hispanic men.[2]
  • No racial or ethnic differences were found among women in the percentage with low HDL cholesterol.[2]
File:Low HDL Percentage in 2010.png

High HDL Epidemiology and Demographics

  • Exact data regarding the prevalence of high HDL serum level is not well documented. On the other hand, the inverse relationship between the HDL level and the risk of cardiovascular disease has been documented by the Framingham Heart Study; for a given level of LDL the risk of heart disease increases 10-fold as the HDL varies from high to low.[4]
  • In 1980, a large cross section study that included 4756 white males and females aged 20 to 59 years was conducted to assess the association of different factors to the HDL level. The study population was further stratified according to age, sex, and gonadal hormone use. Higher levels of HDL have been associated with female gender, moderate alcohol consumption and exercise.[5]
  • Another study that compared the demographic and behavioral correlates of HDL-cholesterol between Northern Italy and the US indicated that physical activity is positively associated with HDL mean levels. The study has found that education level is positively associated with HDL levels only in the American sample.[6]

References

  1. National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) (2002). "Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report". Circulation. 106 (25): 3143–421. PMID 12485966.
  2. 2.0 2.1 2.2 2.3 Carroll MD, Kit BK, Lacher DA (2012). "Total and high-density lipoprotein cholesterol in adults: National Health and Nutrition Examination Survey, 2009-2010". NCHS Data Brief (92): 1–8. PMID 22617230.
  3. "Epidemiology of low HDL-cholesterol: results of studies and surveys". Retrieved 20 September 2013.
  4. Rahilly-Tierney CR, Spiro A, Vokonas P, Gaziano JM (2011). "Relation between high-density lipoprotein cholesterol and survival to age 85 years in men (from the VA normative aging study)". Am J Cardiol. 107 (8): 1173–7. doi:10.1016/j.amjcard.2010.12.015. PMID 21296318.
  5. Heiss G, Johnson NJ, Reiland S, Davis CE, Tyroler HA (1980). "The epidemiology of plasma high-density lipoprotein cholesterol levels. The Lipid Research Clinics Program Prevalence Study. Summary". Circulation. 62 (4 Pt 2): IV116–36. PMID 7418140.
  6. Ferrario M, Cesana GC, Heiss G, Linn SA, Mocarelli P, Tyroler HA (1992). "Demographic and behavioural correlates of high density lipoprotein cholesterol. An international comparison between northern Italy and the United States". Int J Epidemiol. 21 (4): 665–75. PMID 1521969.


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