Twenty-year trends in serum cholesterol, hypercholesterolemia, and cholesterol medication use: The Minnesota heart survey, 1980-1982 to 2000-2002

Background—Although US cholesterol concentrations have dropped, 50 % of adults have total cholesterol concentra-tions 5.18 mmol/L, putting them at “borderline-high risk ” for heart disease. Whether the decline has continued into the 21st century is unknown. We assessed 20-year trends in cholesterol, hypercholesterolemia, lipid-lowering drug use, and cholesterol awareness, treatment, and control from Minnesota Heart Survey (MHS) data. Methods and Results—Five independent, cross-sectional, population-based surveys of 2500 to 5000 adults were conducted in the Minneapolis–St. Paul, Minn, area from 1980 to 2002. Mean (nonfasting) total cholesterol concentrations have continued a 20-year decline, punctuated by an intervening lull. Age-adjusted mean total cholesterol concentrations i