{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:34:35Z","timestamp":1790634875068,"version":"4.1.0"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Cross\u2010sectional analyses suggest that total and low\u2010density lipoprotein cholesterol (LDL\u2010c) trends that had been declining are now reversing. We examined longitudinal data from the Coronary Artery Risk Development in Young Adults (\n              <jats:styled-content style=\"fixed-case\">CARDIA<\/jats:styled-content>\n              ) study to examine secular trends in total cholesterol,\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010c, high\u2010density lipoprotein cholesterol (\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010c), and triglycerides over 25\u00a0years. We also assessed whether modifiable lifestyle factors (body mass index, physical activity, alcohol consumption, smoking, and lipid\u2010lowering medications) are associated with these trends.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">CARDIA<\/jats:styled-content>\n              recruited 5115 black and white men and women ages 18 to 30\u00a0years from 4\n              <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n              communities in 1985\u20131986, and re\u2010examined them 5, 10, 15, 20, and 25\u00a0years later. Secular trends, modeled as age\u2010matched time trends, were estimated using repeated\u2010measures regression stratified on race and sex. Total cholesterol and\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010c initially decreased \u22485 to 8\u00a0mg\/dL between visits before plateauing and moving toward adverse trends in all groups, except black women, by year 25.\n              <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content>\n              \u2010c showed an upward secular trend of 1 to 3\u00a0mg\/dL between visits starting at year 15 in all groups; triglyceride trends were largely flat. Obesity and use of lipid\u2010lowering medications, which both increased over follow\u2010up, had strong independent, but opposite, associations with lipid trends over time. In aggregate, associations of modifiable lifestyle factors counterbalanced one another, minimally influencing secular trends.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Over 25\u00a0years, initially favorable trends in total cholesterol and\n              <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content>\n              \u2010c have leveled off and may be reversing, persisting after control for modifiable risk factors. Factors such as dietary changes over 25\u00a0years and poor adherence to medications are candidates for additional investigation.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.003384","type":"journal-article","created":{"date-parts":[[2017,9,18]],"date-time":"2017-09-18T10:10:42Z","timestamp":1505729442000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Twenty\u2010Five Year Secular Trends in Lipids and Modifiable Risk Factors in a Population\u2010Based Biracial Cohort: The Coronary Artery Risk Development in Young Adults (CARDIA) Study, 1985\u20132011"],"prefix":"10.1161","volume":"5","author":[{"given":"Pamela J.","family":"Schreiner","sequence":"first","affiliation":[{"name":"University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan D.","family":"Wong","sequence":"additional","affiliation":[{"name":"University of California Irvine, Irvine, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina I.","family":"Kiefe","sequence":"additional","affiliation":[{"name":"University of Massachusetts Medical School, Worcester, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03340270029025"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03340270043026"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1986.03380200061022"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(80)90516-0"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.14.1773"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.13260"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.750117"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-511X-7-40"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.549857"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(88)90080-7"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-198911000-00003"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000000278"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8223(21)01299-2"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0076-6879(86)29064-3"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/28.6.1379"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/18.6.499"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2004.037630"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19990330)18:6<655::AID-SIM62>3.0.CO;2-U"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(96)00005-1"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1987.03390070057023"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.4.356"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.15.1868"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq367"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(97)00130-0"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980007000985"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.acvd.2009.02.002"},{"key":"e_1_3_4_28_2","first-page":"83","article-title":"Trends in cardiovascular risk factor levels in Finnish children and young adults from the 1970s: the Cardiovascular Risk in Young Finns Study","volume":"11","author":"Viikari JS","year":"2006","unstructured":"Viikari JS, Juonala M, Raitakari OT. 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