Over the past 10 years, the association between high levels of serum cholesterol and increased risk of coronary heart disease (CHD) has been well documented (1). In addition, a growing body of evidence demonstrates that individuals with elevated cholesterol levels can reduce their risk of CHD by lowering their serum cholesterol and that a 1% decline in serum cholesterol results in a 2% decline in the risk of cardiovascular disease (2). The 3%-4% decline in serum cholesterol reported among U.S. adults from 1960 to 1980 has probably contributed to the overall decline in CHD mortality observed during this period (3). In November 1985, the National Heart, Lung, and Blood Institute (NHLBI) initiated the National Cholesterol Education Program (NCEP), a cooperative undertaking by health organizations in the United States (4). The goal of the program is to contribute to lowering the morbidity and mortality from CHD by reducing the prevalence of elevated serum cholesterol in this country.* The NCEP focuses on public education; its central theme is "Know your blood cholesterol number." Individuals are encouraged to ask about serum cholesterol the next time they see their doctor; to have their cholesterol tested if they have not already done so; to know their number, or level; and to learn whether their cholesterol level needs to be lower. To determine the proportion of adults who report having taken these steps, data from the 33 states (including the District of Columbia) that participated in the 1987 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Since 1984, state health departments have collected these data by conducting telephone surveys of the adult residents of their states (5). Telephone surveys using random-digit dialing are conducted every month throughout the year, and approximately 1,500 interviews are completed annually in each state. Respondents are selected randomly from all adults living in each household. The results presented here are weighted to account for the age, race, and sex distribution of adults in each state in 1980 as well as for the respondents' probability of selection. *A serum cholesterol level of 240 mg/dL or greater is considered "high"; 200 to 239 mg/dL is considered "borderline-high"; and less than 200 mg/dL is aggredd 1 8 SERVICE MAY 1988 (4). U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE Documents Center 1. Centers for Disease Control. Influenza-United States. MMWR 1988;37:207-9. 2. Harmon MW, Rota PA, Walls HH, Kendal AP. Antibody response in humans to influenza virus type B host-cell-derived variants after vaccination with standard (egg-derived) vaccine or natural infection. J Clin Microbiol 1988;26:333-7. 3. World Health Organization. Recommended composition of influenza virus vaccines for use in the 1988-89 season. Wkly Epidem Rec 1988;9:57-60. ✩U.S. Government Printing Office: 1988-530-111/60073 Region IV UNIVERSITY OF MICHIGAN UNITED STATES GOVERNMENT PRINTING OFFICE SUPERINTENDENT OF DOCUMENTS Washington, D.C. 20402 OFFICIAL BUSINESS Penalty for Private Use, $300 BULK RATE POSTAGE & FEES PAID GPO MAY Forgi1988-26 DEPOSITED Bi UNITED STATES OF AMERICA MMWR UNIV 000UADS 278 F 1 UNTV OF MICHIGAN HARLAN HATCHER LIBRARY DOCUMENTS CENTER ANN ARBOR ΜΙ 48109 Redistribution using indicia is illegal. Over the past 10 years, the association between high levels of serum cholesterol and increased risk of coronary heart disease (CHD) has been well documented (1). In addition, a growing body of evidence demonstrates that individuals with elevated cholesterol levels can reduce their risk of CHD by lowering their serum cholesterol and that a 1% decline in serum cholesterol results in a 2% decline in the risk of cardiovascular disease (2). The 3%-4% decline in serum cholesterol reported among U.S. adults from 1960 to 1980 has probably contributed to the overall decline in CHD mortality observed during this period (3). In November 1985, the National Heart, Lung, and Blood Institute (NHLBI) initiated the National Cholesterol Education Program (NCEP), a cooperative undertaking by health organizations in the United States (4). The goal of the program is to contribute to lowering the morbidity and mortality from CHD by reducing the prevalence of elevated serum cholesterol in this country.* The NCEP focuses on public education; its central theme is "Know your blood cholesterol number." Individuals are encouraged to ask about serum cholesterol the next time they see their doctor; to have their cholesterol tested if they have not already done so; to know their number, or level; and to learn whether their cholesterol level needs to be lower. To determine the proportion of adults who report having taken these steps, data from the 33 states (including the District of Columbia) that participated in the 1987 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed. Since 1984, state health departments have collected these data by conducting telephone surveys of the adult residents of their states (5). Telephone surveys using random-digit dialing are conducted every month throughout the year, and approximately 1,500 interviews are completed annually in each state. Respondents are selected randomly from all adults living in each household. The results presented here are weighted to account for the age, race, and sex distribution of adults in each state in 1980 as well as for the respondents' probability of selection. *A serum cholesterol level of 240 mg/dL or greater is considered "high"; 200 to 239 mg/dL is considered "borderline-high"; and less than 200 mg/dL is aggredfdACH (4). SERVICE AYBLIC U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES/PUBLIC HEALTH SERVICE Documents Center The 1987 survey included three questions regarding cholesterol testing and awareness. Respondents were asked whether they had ever had their cholesterol tested. If so, they were asked whether they had been told their cholesterol level, and those who had been given this information were asked what their level was. The proportion of adults in each state who reported having had their cholesterol tested ranged from 29% to 57%, with a median of 47% (Table 1). The proportion of adults who reported being told their value ranged from 3% to 29%, with a median of 19%. Finally, the proportion of adults who were able to provide a value for their cholesterol ranged from 1% to 9%, with a median of 6% (Figure 1). Although current levels of individual cholesterol awareness in the United States are low, they appear to be increasing. Surveys conducted by the NHLBI in 1983 and and again in 1986 show that the proportion of adults in the United States who reported that their serum cholesterol had been checked rose from 35% to 46%, and the proportion who claimed to know their cholesterol level rose from 3% to 7% (6). The proportion of U.S. adults who had had their cholesterol tested (46%) and who knew their cholesterol level (7%) in 1986 are similar to the median values of the states participating in the 1987 BRFSS (47% and 5%). Reported by: R Strickland, Alabama Dept of Public Health. T Hughes, Arizona Dept of Health Svcs. L Parker, California Dept of Health Svcs. C Mitchell, District of Columbia Dept of Human Svcs. S Hoecherl, Florida Dept of Health and Rehabilitative Svcs. JD Smith, Georgia Dept of Human Resources. E Tash, Hawaii Dept of Health. J Mitten, Idaho Dept of Health and Welfare. B Stiner, Illinois Dept of Public Health. S Joseph, Indiana State Board of Health. K Bramblett, Kentucky Cabinet for Human Resources. M Gay, Maine Dept of Human Svcs. A Winestein, Maryland State Dept of Health and Mental Hygiene. L Koumjian, Massachusetts Dept of Public Health. N Salem, Minnesota Center for Health Statistics. M Van Tuinen, Missouri Dept of Health. R Moon, Montana State Dept of Health and Environmental Sciences. R Thurber, Nebraska State Dept of Health. K Zaso, New Hampshire State Dept of Health and Welfare. L Pendley, FIGURE 1. Percentage of respondents who claim to know their cholesterol level, by state - Behavioral Risk Factor Surveillance System, 1987 |