Table 3.
Trends in glycemic, blood pressure, and lipids control among US adultsa.
| Weighted Prevalence (95% Confidence Interval), %b | Absolute | ||||||
|---|---|---|---|---|---|---|---|
| 2001–2004 | 2005–2008 | 2009–2012 | 2013–2016 | 2017–2020 | P trendc | changed, % | |
| Diabetes (n = 4,559) | |||||||
| Diagnostic rate | 82.2 (78.5–85.9) | 79.4 (74.7–84.1) | 82.1 (78.6–85.7) | 88.1 (85.1–91.0) | 84.6 (81.4–87.8) | 0.009 | 2.4 (−2.5 to 7.2) |
| Medicine for diabetes | 64.4 (60.3–68.5) | 66.5 (61.5–71.5) | 69.1 (66.2–71.9) | 75.9 (72.9–78.9) | 73.7 (70.3–77.1) | <0.001 | 9.3 (4.0 to 14.6) |
| HbA1c < 8% | 75.0 (70.8–79.3) | 78.5 (74.8–82.3) | 76.9 (72.8–81.0) | 73.2 (69.7–76.7) | 77.7 (72.9–82.5) | 0.814 | 2.6 (−3.8 to 9.0) |
| HbA1c < 7% | 56.7 (52.5–61.0) | 55.5 (50.0–60.9) | 54.1 (49.1–59.1) | 52.3 (48.1–56.5) | 57.7 (51.6–63.7) | 0.828 | 0.9 (−6.5 to 8.3) |
| Hypertensione (n = 12,072) | |||||||
| Diagnostic rate | 78.0 (75.4–80.6) | 82.3 (80.4–84.3) | 83.6 (81.3–85.8) | 85.2 (83.3–87.0) | 80.4 (77.7–83.2) | 0.022 | 2.4 (−1.4 to 6.3) |
| Medicine for hypertension | 59.9 (56.1–63.6) | 63.9 (61.5–66.3) | 67.2 (64.0–70.3) | 65.7 (62.5–69.0) | 64.8 (62.3–67.4) | 0.018 | 5.0 (0.4 to 9.5) |
| BP < 140/90 mmHg | 46.6 (43.4–49.9) | 55.2 (52.6–57.9) | 59.9 (57.4–62.4) | 58.3 (54.7–62.0) | 55.1 (52.1–58.1) | <0.001 | 8.5 (4.0 to 12.9) |
| BP < 130/80 mmHg | 25.7 (23.0–28.4) | 32.4 (29.3–35.5) | 38.8 (35.7–41.8) | 36.2 (33.0–39.4) | 36.3 (33.2–39.5) | <0.001 | 10.6 (6.5 to 14.7) |
| Dyslipidemiaf (n = 16,139) | |||||||
| Diagnostic rate | 58.4 (55.4–61.4) | 63.4 (61.3–65.6) | 65.2 (62.8–67.7) | 69.9 (67.7–72.2) | 71.0 (67.6–74.4) | <0.001 | 12.6 (8.1 to 17.1) |
| Medicine for dyslipidemia | 26.3 (24.0–28.6) | 34.7 (32.3–37.2) | 36.5 (34.3–38.7) | 36.6 (34.4–38.9) | 36.6 (32.5–40.6) | <0.001 | 10.3 (5.6 to 14.9) |
| Non-HDL-C < 130 mg/dl | 16.3 (14.3–18.2) | 24.4 (22.6–26.3) | 27.4 (25.1–29.7) | 31.4 (29.3–33.6) | 32.9 (28.6–37.2) | <0.001 | 16.6 (11.9 to 21.4) |
| HDL-C ≥ 60 mg/dl | 22.7 (20.7–24.7) | 24.3 (22.6–26.0) | 22.7 (20.1–25.3) | 26.5 (24.0–28.9) | 25.1 (22.3–27.8) | 0.049 | 2.4 (−1.0 to 5.8) |
| Recommend stating (n = 10,689) | |||||||
| Prevalence of statin use | 20.0 (18.0–21.9) | 28.3 (25.9–30.7) | 30.8 (28.0–33.6) | 36.3 (33.6–39.0) | 36.4 (32.2–40.7) | <0.001 | 16.5 (11.8 to 21.2) |
| TC < 200 mg/dl | 36.1 (34.0–38.2) | 42.4 (39.8–45.1) | 48.8 (45.3–52.3) | 50.1 (47.9–52.3) | 55.4 (50.1–60.8) | <0.001 | 19.4 (13.6 to 25.1) |
| LDL-C < 100 mg/dl | 19.5 (16.9–22.0) | 31.3 (28.6–34.1) | 34.2 (30.7–37.8) | 38.2 (35.6–40.8) | 40.3 (35.6–45.0) | <0.001 | 20.9 (15.5 to 26.2) |
BP, blood pressure; non-HDL, non-high density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; TC, total cholesterol; LDL-C, low-density lipoprotein cholesterol; ASCVD, atherosclerotic cardiovascular disease.
Participants aged 40–79 years without clinical ASCVD and all variables of the Pooled Cohort Equations were included. Diagnosed diabetes, hypertension, and dyslipidemia were defined as self-reported diagnosis or taking drugs. To convert TC, LDL-C, HDL-C, and non-HDL-C to mmol/l, multiply values by 0.0259. To convert triglycerides to mmol/l, multiply values by 0.0113.
Estimates were age- and sex-adjusted by the direct method to the 2017–2018 NHANES adults without pre-existing ASCVD.
The statistical significance of a linear trend was assessed using the weighted regression and modeling the midpoint of each time period.
Indicates the absolute increase in prevalence of glycemic, blood pressure, and lipid control between 2001 and 2004 and 2017 to 2020. Values are percentages (95% CIs).
Hypertension was defined as a self-reported diagnosis of hypertension, currently taking antihypertensive drugs, or diagnosed as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg.
Dyslipidemia was defined as at least one abnormality in TC, LDL-C, TG, or HDL-C or self-reported diagnosis of high cholesterol level or taking lipid-lowering drugs.
Recommend statin was defined as (1) LDL > 190 mg/dl or (2) one or more CVD risk factors (i.e., dyslipidemia, diabetes, hypertension, or smoking) with projected 10-year ASCVD risk ≥7.5%.