OBJECTIVES: Hyperlipidemia is a major risk factor for cardiovascular diseases, and treatment and control of hyperlipidemia reduces risk. The objective of this study was to examine trends in the prevalence of hyperlipidemia, awareness, treatment, and control among United States adults. METHODS: We used data of 13,112 United States adults (age ≥ 20 years) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2010 (this is a cross-sectional health examination survey of the US population) and who had a diagnosis for hyperlipidemia or reported using cholesterol-lowering medications and who participated in the National Health and Nutrition and had a total cholesterol determination. RESULTS: The prevalence of hyperlipidemia ranged from 55.58% to 53.83% and changed little over the study period. For all adults, the age-adjusted mean total cholesterol concentration decreased from 225.75±2.87 to 215.55±3.39 (p<0.01). Significant decreases were observed among African American population. Among participants who had a total cholesterol concentration > 200 mg/dL or who reported using cholesterol-lowering medications, 28.9% were aware that they had hyperlipidemia, 26.2% were on treatment, and 12.0 had a total cholesterol concentration < 200 mg/dL after age adjustment. Lifestyle proved to play a major role is control of hyperlipidemia. The smokers were 3-4% (p<0.001) less in the control group as compared to non-smokers. The people who engaged in vigorous intensity activity were 2-3% (p<0.001) more in the control group than the ones who engaged in moderate intensity activity. Insurance played an important role in treatment. Percent of population with insurance receiving treatment was about 50% (p<0.001) more than the percent of population without insurance. CONCLUSIONS: Although the increases in awareness and treatment of hyperlipidemia are encouraging, control remains poor. The lower percentage of controlled blood cholesterol stresses the need for better prevention and treatment programs for hyperlipidemia.