In this issue of JAMA, Kuklina and colleagues1 report trends over the last decade in cholesterol levels and treatment. While the decreasing prevalence of “high” low-density lipoprotein cholesterol (LDL-C) levels and increasing use of lipid-lowering medications in appropriate individuals are encouraging, the most sobering message in this article is the disappointing rates of screening, awareness, and treatment. Among those with high LDL-C levels, one-third had not been screened, and one-fourth were unaware that their levels were high. About two-thirds of those who were high risk were not receiving medication, although the vast majority of these individuals would likely benefit from lipid-lowering therapy.
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