In 2021, 37.7 percent of Delaware residents ages 18 years and older reported they had been diagnosed with high blood cholesterol.  That means more than 260,000 Delaware adults know they have high cholesterol, according to the Delaware Behavioral Risk Survey (BRFS).  Cholesterol is a waxy, fat-like substance found in the blood.  The body needs it to build healthy cells.  However, when there is too much cholesterol in the blood, it can build up in the arteries reducing the space for blood to flow, causing less blood to flow to the heart and other organs.

Prevalence of High Cholesterol

Trend in Adult High Cholesterol Prevalence in Delaware:

• 2011 = 40.6 percent
• 2013 = 40.6 percent
• 2015 = 39.1 percent
• 2017 = 34.6 percent*
• 2019 = 35.4 percent*
• 2021 = 37.7 percent

* The significantly lower prevalence in 2017 may, at least in part, be a result of a change in the way the cholesterol questions were asked. This may require a break in the trend line, with 2017 as the new baseline.

The BRFS asks cholesterol questions every other year, in odd-numbered years.

The prevalence of high cholesterol increases with age. Only 19.0 percent of Delaware adults ages 18-44 have been told they have high cholesterol.  However, 38.1 percent of adults ages 45-54, 48.5 percent of adults age 55-64, and 53.8 percent of adults ages 65 years and older have been told they have high cholesterol.  These increases are statistically significant.

Women have a slightly lower prevalence of high cholesterol compared to men; 35.9 percent of Delaware women have been told they have high cholesterol, compared to 39.6 percent of men. This difference is NOT statistically significant.

Non-Hispanic white Delaware adults reported having slightly higher prevalence of high cholesterol (40.8 percent) than Black adults (33.8 percent) and Hispanic adults (25.6 percent). The difference between white and Hispanic adults was statistically significant.

There were no significant differences reported among those with different educational attainment: 39.5 percent of Delaware adults with less than a high school diploma reported having high cholesterol, 34.6 percent of Delaware adults with a high school diploma reported having high cholesterol, 38.2 percent of Delaware adults with some post high school education reported having high cholesterol, and 39.9 percent of Delaware adults with a college degree reported having high cholesterol. 

Testing for Blood Cholesterol

The National Cholesterol Education Program (NCEP) recommends adults ages 20 and older should have their cholesterol checked every 5 years.  Of Delaware adults aged 20 years and older, 95.4 percent reported having their blood cholesterol level tested within the last five years.

For those with borderline high or high cholesterol, recommendations on how often a cholesterol test is required should be made by a health care professional.

Risk Factors

There are several risk factors for high cholesterol, including existing health conditions, behavioral risks, and family history or genetics.

Diabetes is known to be associated with high cholesterol.  Of Delaware adults who have diabetes, 63.5 percent also have high cholesterol.  When adjusted for other demographic characteristics and risk factors, Delaware adults with diabetes were still more likely to have high cholesterol than adults without diabetes.

Behavioral risk factors include poor diet, physical inactivity, obesity, smoking, and excessive drinking.

Prevalence of high cholesterol among adults who are physically inactive is 42.3 percent; and the prevalence among obese adults is 42.1 percent.  Adults who smoke cigarettes have a high cholesterol prevalence of 37.5 percent.  Those who report chronic heavy alcohol use have a high cholesterol prevalence of 43.9 percent. The highest prevalence (46.7 percent) is among adults with disabilities.   The underlying causes of those disabilities may be conditions which increase the risk for high cholesterol.

Family history and genetics are likely to play a role in whether an individual develops high cholesterol.  For example, the risk of high cholesterol can increase when someone who has a family history of hypertension also engages in other behavioral risk factors, such as physical inactivity.

Complications: High cholesterol is a risk factor for heart disease.  Some of the conditions to which high cholesterol can contribute include heart attack, angina or chest pain, stroke, and aortic aneurysm.

What You Can Do:

Take medicines as prescribed by your doctor. There are medications which can help lower or control high cholesterol, decreasing your risk of complications.  If a medication is prescribed to you, take it as instructed.  If your risk factors change (for example, if you start an exercise program or change your diet), tell your doctor or health care team because your medication may need to be adjusted.

Make Healthy Lifestyle Changes

• Manage any health conditions you may have.  If you need help learning to manage any chronic disease with which you may have been diagnosed, the Division of Public Health offers free classes.  A class schedule is available the HealthyDelaware.org website.
• Eat a diet high in vegetables and fruits, and low in saturated fats, refined carbohydrates, and sugars.  Eat primarily high nutrient, low-calorie foods.
• Maintain a healthy weight.
• Be physically active, including both strength-building and aerobic exercise.  Children and youth should get an hour of physical activity daily, and adults should get at least 30 minutes a day at least 5 days a week.
• Don’t smoke.  If you don’t smoke, don’t start.  If you smoke, try to quit; and don’t expose others to your second-hand smoke.  If you need help quitting, call the toll-free Delaware Quitline at 1-866-409-1858.
• If you drink alcoholic beverages, do so in moderation — up to one per day for women or smaller adults, or up to two per day for men or larger adults.  Never drink when it could put you or others at risk.  Women who are pregnant should not drink alcohol.
• For more information regarding heart disease and other chronic diseases and their related risk factors, visit HealthyDelaware.org.

A printable PDF version of this page is available here.

Return to the main Delaware BRFS page.