Prevalence of and Trends in Dyslipidemia and Blood Pressure Among US Children and Adolescents, 1999-2012 | Journal Scan

Study Questions:

Have the prevalence and trends in dyslipidemia and blood pressure (BP) changed over time among US children and adolescents?


Data from the National Health and Nutrition Examination Survey (NHANES), a cross-sectional survey of noninstitutionalized people living in the United States, were used for the present analysis. For this study, children and adolescents ages 8-17 years with available lipid levels and BPs were included. Adverse concentrations of total cholesterol (TC) (≥200 mg/dl), high-density lipoprotein cholesterol (HDL-C) (<40 mg/dl), and non–HDL-C (≥145 mg/dl) (to convert TC, HDL-C, and non–HDL-C to millimoles per liter, multiply by 0.0259) and high or borderline BP were examined. Definitions of BP were informed by the Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents by the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Analyses of linear trends in dyslipidemias and BP were conducted overall and separately by sex across seven periods (1999-2000, 2001-2002, 2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012).


In 2011-2012, 20.2% (95% confidence interval [CI], 16.3-24.6) of youths had an adverse concentration of TC, HDL-C, or non–HDL-C and 11.0% (95% CI, 8.8-13.4) had either high or borderline BP. The prevalence of adverse concentrations decreased between 1999-2000 and 2011-2012 for TC (10.6% [95% CI, 8.3-13.2] vs. 7.8% [95% CI, 5.7-10.4]; p = 0.006), HDL-C (17.9% [95% CI, 15.0-21.0] vs. 12.8% [95% CI, 9.8-16.2]; p = 0.003), and non–HDL-C (13.6% [95% CI, 11.3-16.2] vs. 8.4% [95% CI, 5.9-11.5]; p < 0.001). There was a decrease in high BP between 1999-2000 (3.0% [95% CI, 2.0-4.3]) and 2011-2012 (1.6% [95% CI, 1.0-2.4]; p = 0.003). There was no change from 1999-2000 to 2011-2012 in borderline high BP (7.6% [95% CI, 5.8-9.8] vs. 9.4% [95% CI, 7.2-11.9]; p = 0.90) or either high or borderline high BP (10.6% [8.4-13.1] vs. 11.0% [95% CI, 8.8-13.4]; p = 0.26).


The authors concluded that in 2011-2012, approximately 1 in 5 children and adolescents ages 8-17 years had an adverse lipid concentration of TC, HDL-C, or non–HDL-C and slightly more than 1 in 10 had either borderline high or high BP. The prevalence of dyslipidemia modestly decreased between 1999-2000 and 2011-2012, but either high or borderline high BP remained stable. The reasons for these trends require further study.


Although the investigators observed modest improvements in lipids and blood pressure among US children and adolescents, there is still a large proportion who have adverse measures. Further monitoring of these trends will help target specific populations most in need of interventions to improve these cardiovascular risk factors.

Clinical Topics: Congenital Heart Disease and Pediatric Cardiology, Diabetes and Cardiometabolic Disease, Dyslipidemia, Prevention, CHD and Pediatrics and Prevention, Lipid Metabolism, Nonstatins, Hypertension

Keywords: Adolescent, Blood Pressure, Blood Pressure Determination, Cardiovascular Diseases, Cholesterol, Cholesterol, HDL, Dyslipidemias, Hypertension, Lipids, Lipoproteins, Lipoproteins, HDL, Prevalence

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