Abstract
Cardiovascular disease is one of the leading causes of death among reproductive-age women. In this study, we examine trends in the prevalence of dyslipidemia, hypertension, and related clinicians’ advice among reproductive-age women. We conducted trend analysis of these factors among non-pregnant women aged 20–49 years (n = 5,768) using National Health and Nutrition Examination Survey (NHANES) data obtained between 1999 and 2008. Multiple linear regression and logistic regression analyses were used to examine linear trends over a 10-year period after adjusting for covariates. A downward trend was observed for the proportion of women with abnormal levels of low density lipoprotein (LDL; P = 0.038) and high density lipoprotein (HDL; P = 0.008) cholesterol from 1999 to 2008. In contrast, no significant changes were observed in the prevalence of abnormal total cholesterol (P = 0.948) and triglyceride levels (P = 0.300), or hypertension (P = 0.632). Based on the self-reported data, upward trends were observed in the rates of cholesterol checking (P = 0.002), high cholesterol (P = 0.012), receiving clinicians’ advice to use lipid-lowering agents (P < 0.001) and patients’ compliance with their advice (P < 0.001). Although rates of self-reported hypertension did not change over time (P = 0.120), receiving clinicians’ advice to use antihypertensive medications (P = 0.003) and patients’ compliance with these medications (P = 0.015) also increased significantly. Overall improvements in LDL and HDL cholesterol over this time period could be due to increases in related awareness, receiving advice to use medications, and patients’ compliance with this advice. Use of antihypertensive medication has also increased among reproductive-age women in the US.
Similar content being viewed by others
References
Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US adults, 1999–2008. JAMA, 303, 235–241.
Centers for Disease Control and Prevention. National center for health statistics: Health data interactive. Available at: http://www.cdc.gov/nchs/hdi.htm. Accessed September 22, 2011.
Boomsma, C. M., Fauser, B. C., & Macklon, N. S. (2008). Pregnancy complications in women with polycystic ovary syndrome. Seminars in Reproductive Medicine, 26(1), 72–84.
Phelan, N., O’Connor, A., Kyaw-Tun, T., Correia, N., Boran, G., Roche, H. M., et al. (2010). Lipoprotein subclass patterns in women with polycystic ovary syndrome (PCOS) compared with equally insulin-resistant women without PCOS. The Journal of Clinical Endocrinology and Metabolism, 95(8), 3933–3939.
Catov, J. M., Ness, R. B., Wellons, M. F., Jacobs, D. R., Roberts, J. M., & Gunderson, E. P. (2010). Prepregnancy lipids related to preterm birth risk: The Coronary Artery Risk Development in Young Adults Study. Journal of Clinical Endocrinology and Metabolism, 95(8), 3711–3718.
Bentley-Lewis, R., Koruda, K., & Seely, E. W. (2007). The metabolic syndrome in women. Nature Clinical Practice Endocrinology & Metabolism, 3(10), 696–704.
Wiznitzer, A., Mayer, A., Novack, V., Sheiner, E., Gilutz, H., Malhotra, A., et al. (2009). Association of lipid levels during gestation with preeclampsia and getational diabetes mellitus: A population-based study. American Journal of Obstetrics and Gynecology, 201, 482.el–488.el.
Craici, I. M., Wagner, S. J., Hayman, S. R., & Garovic, V. D. (2008). Pre-eclamptic pregnancies: An opportunity to identify women at risk for future cardiovascular disease. Womens Health, 4, 133–135.
Golden, S. H., Bennett, W. L., Baptist-Roberts, K., Wilson, M. N., Barone, B., Gary, T. L., et al. (2009). Antepartum glucose tolerance test results as predictor of type 2 diabetes mellitus in women with a history of gestational diabetes mellitus: A systematic review. Gender Medicine, 6, 109–122.
Duckitt, K., & Harrington, D. (2005). Risk factors for pre-eclampsia at antenatal booking: Systematic review of controlled studies. BMJ, 330(7491), 565.
Ferrer, R. L., Sibai, B. M., Mulrow, C. D., Chiquette, E., Stevens, K. R., & Cornell, J. (2000). Management of mild chronic hypertension during pregnancy: A review. Obstetrics and Gynecology, 96(5 Pt 2), 849–860.
Livingston, J. C., Maxwell, B. D., & Sibai, B. M. (2003). Chronic hypertension in pregnancy. Minerva Ginecologica, 55(1), 1–13.
Simpson, L. L. (2002). Maternal medical disease: Risk of antepartum fetal death. Seminars in Perinatology, 26(1), 42–50.
Rich-Edwards, J. W., McElrath, T. F., Karumanchi, S. A., & Seely, E. W. (2010). Breathing life into the life course approach: Pregnancy history and cardiovascular disease in women. Hypertension, 56, 331–334.
Carroll, M. D., Lacher, D. A., Sorlie, P. D., Cleeman, J. I., Gordon, D. J., Wolz, M., et al. (2005). Trends in serum lipids and lipoproteins of adults, 1960–2002. JAMA, 294, 1773–1781.
Cohen, J. D., Cziraky, M. J., Cai, Q., Wallace, A., Wasser, T., Crouse, J. R., et al. (2010). 30-year trends in serum lipids among United States adults: Results from the National Health and Nutrition Examination Surveys II, III, and 1999–2006. American Journal of Cardiology, 106, 969–975.
Kuklina, E. V., Yoon, P. W., & Keenan, N. L. (2009). Trends in high levels of low-density lipoprotein cholesterol in the United States, 1999–2006. JAMA, 302, 2104–2110.
Hyre, A. D., Muntner, P., Menke, A., Raggi, P., & Jiang, A. (2007). Trends in ATP-III- defined High blood cholesterol prevalence, awareness, treatment and control among US adults. Annals of Epidemiology, 17, 548–555.
Mann, D., Reynolds, K., Smith, D., & Muntner, P. (2008). Trends in statin use and low-density lipoprotein cholesterol levels among US adults: Impact of the 2001 National Cholesterol Education Program Guideline. Annals of Pharmacotherapy, 42, 1208–1215.
Cutler, J. A., Sorlie, P. D., Wolz, M., Thom, T., Fields, L. E., & Roccella, E. J. (2008). Trends in hypertension prevalence, awareness, treatment, and control rates in United States adults between 1988–1994 and 1999–2004. Hypertension, 52, 818–827.
Egan, B. M., Zhao, Y., & Axon, R. N. (2010). US trends in prevalence, awareness, treatment, and control of hypertension, 1988–2008. JAMA, 303, 2043–2050.
Centers for Disease Control and Prevention. National health and nutrition examination survey: Questionnaires, datasets, and related documentation. Available at: http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed April 17, 2011.
Centers for Disease Control and Prevention. National health and nutrition examination survey: 2007–2008 data documentation, code book, and frequencies. Triglycerides and LDL-cholesterol (TRIGLY_E). Available at: http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/TRIGLY_E.htm. Accessed on April 17, 2011.
Centers for Disease Control and Prevention. National health and nutrition examination survey: 2007–2008 data documentation, code book, and frequencies. Total cholesterol (TCHOL_E). Available at: http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/TCHOL_E.htm. Accessed on April 17, 2011.
Centers for Disease Control and Prevention. National health and nutrition examination survey: 2007–2008 data documentation, code book, and frequencies. HDL-cholesterol (HDL_E). Available at: http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/HDL_E.htm. Accessed on April 17, 2011.
Ford, E. S., Mokdad, A. H., Giles, W. H., & Mensah, G. A. (2003). Serum total cholesterol concentrations and awareness, treatment, and control of hypercholesterolemia among US adults: Findings from the National Health and Nutrition Examination Survey, 1999 to 2000. Circulation, 107, 2185–2189.
Myers, G. L., Cooper, G. R., Winn, C. L., & Smith, S. J. (1989). The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. Clinics in Laboratory Medicine, 9, 105–135.
Friedewald, W. T., Levy, R. I., & Fredrickson, D. S. (1972). Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clinical Chemistry, 18, 499–502.
National Cholesterol Education Program (NCEP) Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult treatment Panel III). 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, 3143–3421.
Perloff, D., Grim, C., Flack, J., Frohlich, E. D., Hill, M., McDonald, M., et al. (1993). Human blood pressure determination by sphygmomanometry. Circulation, 88, 2460–2470.
Ong, K. L., Cheung, B. M. Y., Man, Y. B., Lau, C. P., & Lam, K. S. L. (2007). Prevalence, awareness, treatment and control of hypertension among United States Adults, 1999–2004. Hypertension, 49, 69–75.
Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L., Jr, et al. (2003). Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension, 42, 1206–1252.
Centers for Disease Control and Prevention. National health and nutrition examination survey (NHANES): Analytic and reporting guidelines. Available at: http://www.cdc.gov/nchs/data/nhanes/nhanes_03_04/nhanes_analytic_guidelines_dec_2005.pdf. Accessed on April 17, 2011.
Mosca, L., Banka, C. L., Benjamin, E. J., Berra, K., Bushnell, C., Dolor, R. J., et al. (2007). Evidence-based guidelines for cardiovascular disease prevention in women: 2007 update. Circulation, 115, 1481–1501.
Carr, M. C., & Brunzell, J. D. (2004). Abdominal obesity and dyslipidemia in the metabolic syndrome: Importance of Type 2 diabetes and Familial combined hyperlipidemia in coronary artery disease risk. The Journal of Clinical Endocrinology and Metabolism, 89, 2601–2607.
Franssen, R., Monajemi, H., Stroes, E. S., & Kastelein, J. J. (2008). Obesity and dyslipidemia. Endocrinology and Metabolism Clinics of North America, 37, 623–633.
Tanko, L. B., Bagger, Y. Z., Qin, G., Alexandersen, P., Larsen, P. J., & Christiansen, C. (2005). Enlarged waist combined with elevated triglycerides is a strong predictor of atherogenesis and related cardiovascular mortality in postmenopausal women. Circulation, 111, 1883–1890.
Gu, Q., Paulose-Ram, R., Dillon, C., & Burt, V. (2006). Antihypertensive medication use among US adults with hypertension. Circulation, 113, 213–221.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Laz, T.H., Rahman, M. & Berenson, A.B. Trends in Serum Lipids and Hypertension Prevalence Among Non-Pregnant Reproductive-Age Women: United States National Health and Nutrition Examination Survey 1999–2008. Matern Child Health J 17, 1424–1431 (2013). https://doi.org/10.1007/s10995-012-1148-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-012-1148-y