Increase in Prevalence of Self-Reported High Blood Cholesterol Among Adults, United States, 2019–2023

Introduction: Elevated levels of total blood cholesterol are associated with an increased risk of atherosclerotic cardiovascular disease. Clinical guidelines and recommendations encourage regular screening and management of blood cholesterol among adults to reduce this risk. This study assessed national and state-level trends in the age-standardized prevalence of self-reported blood cholesterol screening and elevated cholesterol levels among adults by using data from the 2019-2023 Behavioral Risk Factor Surveillance System. Methods: Age-standardized prevalence of blood cholesterol screening during the preceding 5 years and high blood cholesterol among those ever screened were assessed by sex, age group, race and ethnicity, educational attainment, and state of residence. Absolute and relative changes from 2019 to 2023 were calculated, and linear and quadratic trends across survey periods were assessed by using orthogonal polynomial coefficients. Results: From 2019 to 2023, the prevalence of adults who had blood cholesterol screened during the preceding 5 years slightly decreased by 0.5%, from 86.0% to 85.6% (-0.4 percentage points, P = .03). Among adults who had ever been screened, the prevalence of awareness for high blood cholesterol increased by 13.7%, rising from 29.2% to 33.2% (4.0 percentage points, P < .001). The prevalence of screening for and awareness of high blood cholesterol varied by sociodemographic characteristics and state of residence. Approximately two-thirds of US states experienced an increase in the prevalence of self-reported high blood cholesterol. Conclusion: To improve cholesterol management, public health and clinical efforts should consider expanding resources and interventions that effectively promote early detection and raise awareness about the importance of cholesterol management.