You are here

HDS-20.1 Data Details

Expand All

HDS-20.1 Increase the proportion of adults with coronary heart disease who have their low-density lipoprotein (LDL) cholesterol at or below recommended levels

About the Data

Description of the data source, numerator, denominator, survey questions, and other relevant details about the national estimate.

Data Source: 
National Health and Nutrition Examination Survey
Changed Since the Healthy People 2020 Launch: 
Yes
Measure: 
percent (age adjusted—see Comments)
Baseline (Year): 
52.3 (2005–08)
Target: 
67.5
Target-Setting Method: 
Minimal statistical significance
Target-Setting Method Justification: 
The target setting method used was Minimal Statistical Significance. The target value of 67.5% represents the smallest change that will result in a statistically meaningful improvement over the baseline value and would yield a realistic, probably attainable target value.
Numerator: 

Number of persons aged 20 years and over with coronary heart disease who have low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL

Denominator: 

Number of persons aged 20 years and over with coronary heart disease

Comparable Healthy People 2010 Objective: 
Retained from HP2010 objective
Questions Used to Obtain the National Baseline Data: 

    From the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey:

    [NUMERATOR AND DENOMINATOR:]

    For persons aged 20 years and over:

    Has a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had coronary heart disease?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    Has a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had angina, also called angina pectoris?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    Has a doctor or other health professional ever told {you/SP} that {you/s/he} . . .had a heart attack (also called myocardial infarction)?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    For persons aged 40 years and over:

    {Have you/Has SP} ever had any pain or discomfort in {your/her/his} chest?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    {Do you/Does she/Does he} get it when {you/she/he} walk uphill or hurry?

    1. Yes
    2. No
    3. Never walks uphill or hurries
    4. Refused
    5. Don't know

    {Do you/Does she/Does he} get it when {you/she/he} walk at an ordinary pace on level ground?

    1. Yes
    2. No
    3. Refused
    4. Don't know

    What {do you/does she/does he} do if {you/she/he} get it while {you/she/he} are walking? {Do you/Does she/Does he} stop or slow down or continue at the same pace?

    1. Stop or slow down
    2. Continue at the same pace
    3. Refused
    4. Don't know

    If {you/she/he} stand still, what happens to it? Is the pain or discomfort relieved or not relieved?

    1. Relieved
    2. Not Relieved
    3. Refused
    4. Don't know

    How soon is the pain relieved? Would you say...

    1. 10 minutes or less
    2. More than 10 minutes
    3. Refused
    4. Don't know

    Please look at this card and show me where the pain or discomfort is located.

    1. Pain in right arm
    2. Pain in right chest

    3. Pain in neck
    4. Pain in upper sternum
    5. Pain in lower sternum
    6. Pain in left chest
    7. Pain in left arm
    8. Pain in epigastric area
Data Collection Frequency: 
Periodic
Methodology Notes: 

    Most of the circulating cholesterol is found in three major lipoprotein fractions: very low-density lipoproteins (VLDL), low-density lipoproteins (LDL), and high-density lipoproteins (HDL). LDL cholesterol is calculated from measured values of total cholesterol, triglycerides, and HDL cholesterol according to the Friedewald calculation: [LDL cholesterol] = [total cholesterol] - [HDL cholesterol] - [triglycerides/5] where [triglycerides/5] is an estimate of VLDL cholesterol and all values are expressed in mg/dL.

    LDL carries most of the circulating cholesterol and, when elevated, contributes to the development of coronary atherosclerosis. LDL- cholesterol is measured to assess risk for CHD and to follow the progress of patients being treated to lower LDL cholesterol concentrations.

    Desirable levels of LDL cholesterol are below 100 mg/dL; borderline low from 100-129 mg/dL; borderline high is from 130-159 mg/dL; high is from 160-189 mg/dL; and very high LDL- cholesterol is greater than or equal to 190 mg/dL.

    Coronary heart disease is defined based on a health care professional's diagnosis of coronary heart disease, angina, or heart attack (also called myocardial infarction) or meeting the criteria for grade 1 angina by the Rose questionnaire assessment. The Rose questionnaire is only administered to survey participants aged 40 years and over. Grade 1 angina is defined based on a positive response to ever having had pain or discomfort in chest and ever getting pain or discomfort in chest when walking up hill or in a hurry (but not getting pain or discomfort in chest when walking at an ordinary pace on level ground) and stopping or slowing down if get it while walking and pain or discomfort relieved when standing still, and pain relieved in 10 minutes or less, plus either pain or discomfort located in upper sternum, lower sternum, or left chest and left arm.

    Age Adjustment Notes: 

    This Indicator uses Age-Adjustment Groups:

    • Total: 20-49, 50-59, 60-69, 70-79, 80+
    • Sex: 20-49, 50-59, 60-69, 70-79, 80+
    • Race/Ethnicity: 20-49, 50-59, 60-69, 70-79, 80+
    • Educational Attainment: 25-49, 50-59, 60-69, 70-79, 80+
    • Family Income (percent poverty threshold): 20-49, 50-59, 60-69, 70-79, 80+
    • Country of Birth: 20-49, 50-59, 60-69, 70-79, 80+
    • Disability Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Health Insurance Status: 20-49, 50-59, 60-64
    • Marital Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Veteran Status: 20-49, 50-59, 60-69, 70-79, 80+
    • Obesity Status: 20-49, 50-59, 60-69, 70-79, 80+

Revision History

Any change to the objective text, baseline, target, target-setting method or data source since the Healthy People 2020 launch.

Description of Changes Since the Healthy People 2020 Launch: 
In 2015, this objective became measurable. In 2017, the target was revised from 66.5% to 67.5% due to a computation error.

References

Additional resources about the objective

  1. National Center for Health Statistics. National Health and Nutrition Examination Survey, 2005-2006, Public Use Medical Conditions Questionnaire Documentation. Hyattsville, MD: Centers for Disease Control and Prevention, November 2007.