Advertisement

Socioeconomic and geographic variations in the prevalence, awareness, treatment and control of dyslipidemia in middle-aged and older Chinese

      Highlights

      • Low HDL is the most common type of dyslipidemia in middle-aged and older Chinese.
      • The prevalence of dyslipidemia is the highest in North China.
      • The awareness, treatment and control of dyslipidemia are poor in Southwest China.

      Abstract

      Background and aims

      Unevenly socioeconomic development and nutrition transition might bring large variations in the epidemiology of dyslipidemia. We aimed to estimate the prevalence, awareness, treatment and control of dyslipidemia in different socioeconomic statuses and geographic regions in China, and to assess the associated factors and comorbidities of dyslipidemia.

      Methods

      We included participants aged 45 years and above from a nationally representative investigation: the China Health and Retirement Longitudinal Study 2011. Dyslipidemia was defined based on the 2016 guideline of Chinese Prevention and Treatment of Dyslipidemia in adults. Multivariable logistic regression was adopted to assess the potentially associated factors and commodities of dyslipidemia.

      Results

      In 2010, the prevalence of dyslipidemia was 42.84% among people aged 45 years and above. Low level of high-density lipoprotein cholesterol (HDL-C) was the most common type of dyslipidemia. The awareness, treatment and control rates among dyslipidemic subjects were 20.27%, 14.41% and 4.94%, respectively. In dyslipidemic patients who were under treatment, the control rate was 34.26%. People aged 50–59 years were at a significantly higher risk of dyslipidemia than those aged 45–49 years. Male gender, living in North China, overweight, obesity, central obesity, hypertension, diabetes and hyperuricemia were significantly associated with a higher risk of dyslipidemia. Current alcohol drinking and underweight were linked to a lower prevalence of dyslipidemia.

      Conclusions

      Our study revealed a high prevalence of dyslipidemia among middle-aged and older Chinese. The awareness, treatment and control rates were far from ideal and geographic inequality was highlighted. More efforts are needed to prevent and manage dyslipidemia in China.

      Graphical abstract

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Roth G.A.
        • Johnson C.
        • Abajobir A.
        • Abd-Allah F.
        • Abera S.F.
        • Abyu G.
        • Ahmed M.
        • Aksut B.
        • Alam T.
        • Alam K.
        Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015.
        J. Am. Coll. Cardiol. 2017; : 23715
        • Bansilal S.
        • Castellano J.M.
        • Fuster V.
        Global burden of CVD: focus on secondary prevention of cardiovascular disease.
        Int. J. Cardiol. 2015; 201: S1-S7
        • Owolabi M.
        • Miranda J.J.
        • Yaria J.
        • Ovbiagele B.
        Controlling cardiovascular diseases in low and middle income countries by placing proof in pragmatism.
        BMJ Glob. Health. 2016; 1: e000105
        • Celermajer D.S.
        • Chow C.K.
        • Marijon E.
        • Anstey N.M.
        • Woo K.S.
        Cardiovascular disease in the developing world: prevalences, patterns, and the potential of early disease detection.
        J. Am. Coll. Cardiol. 2012; 60: 1207-1216
        • Wei-Wei C.
        • Run-Lin G.
        • Li-Sheng L.
        • Man-Lu Z.
        • Wen W.
        • Yong-Jun W.
        • Zhao-Su W.
        • Hui-Jun L.
        • Dong-Feng G.
        • Yue-Jin Y.
        China cardiovascular diseases report 2015: a summary.
        J. Geriatr. Cardiol.: JGC. 2017; 14: 1
        • Yang Z.-J.
        • Liu J.
        • Ge J.-P.
        • Chen L.
        • Zhao Z.-G.
        • Yang W.-Y.
        Prevalence of cardiovascular disease risk factor in the Chinese population: the 2007–2008 China national diabetes and metabolic disorders study.
        Eur. Heart J. 2011; 33: 213-220
        • Catapano A.L.
        • Graham I.
        • De Backer G.
        • Wiklund O.
        • Chapman M.J.
        • Drexel H.
        • Hoes A.W.
        • Jennings C.S.
        • Landmesser U.
        • Pedersen T.R.
        • Reiner Z.
        • Riccardi G.
        • Taskinen M.R.
        • Tokgozoglu L.
        • Verschuren W.M.
        • Vlachopoulos C.
        • Wood D.A.
        • Zamorano J.L.
        2016 ESC/EAS guidelines for the management of dyslipidaemias: the task force for the management of dyslipidaemias of the european society of cardiology (ESC) and european atherosclerosis society (EAS) developed with the special contribution of the european assocciation for cardiovascular prevention & rehabilitation (EACPR).
        Atherosclerosis. 2016; 253: 281-344https://doi.org/10.1016/j.atherosclerosis.2016.08.018
        • Rosamond W.
        • Flegal K.
        • Friday G.
        • Furie K.
        • Go A.
        • Greenlund K.
        • Haase N.
        • Ho M.
        • Howard V.
        • Kissela B.
        Heart disease and stroke statistics—2007 update: a report from the American heart association statistics committee and stroke statistics subcommittee.
        Circulation. 2007; 115: e69-e171
        • Gupta R.
        • Sharma K.K.
        • Gupta B.K.
        • Gupta A.
        • Saboo B.
        • Maheshwari A.
        • Mahanta T.
        • Deedwania P.C.
        Geographic epidemiology of cardiometabolic risk factors in middle class urban residents in India: cross–sectional study.
        J. Glob. Health. 2015; 5
        • Luo J-y
        • Ma Y.-T.
        • Yu Z-x
        • Yang Y.-N.
        • Xie X.
        • Ma X.
        • Liu F.
        • Li X-m
        • Chen B-d
        Prevalence, awareness, treatment and control of dyslipidemia among adults in Northwestern China: the cardiovascular risk survey.
        Lipids Health Dis. 2014; 13: 4
        • Song P.
        • Wang H.
        • Xia W.
        • Chang X.
        • Wang M.
        • An L.
        Prevalence and correlates of hyperuricemia in the middle-aged and older adults in China.
        Sci. Rep. 2018; 8: 4314
        • Zhang F.-L.
        • Xing Y.-Q.
        • Wu Y.-H.
        • Liu H.-Y.
        • Luo Y.
        • Sun M.-S.
        • Guo Z.-N.
        • Yang Y.
        The prevalence, awareness, treatment, and control of dyslipidemia in northeast China: a population-based cross-sectional survey.
        Lipids Health Dis. 2017; 16: 61
        • Pan L.
        • Yang Z.
        • Wu Y.
        • Yin R.-X.
        • Liao Y.
        • Wang J.
        • Gao B.
        • Zhang L.
        • Group CNSoCKDW.
        The prevalence, awareness, treatment and control of dyslipidemia among adults in China.
        Atherosclerosis. 2016; 248: 2-9
        • Cai L.
        • Zhang L.
        • Liu A.
        • Li S.
        • Wang P.
        Prevalence, awareness, treatment, and control of dyslipidemia among adults in Beijing, China.
        J. Atherosclerosis Thromb. 2012; 19: 159-168
        • Zhao Y.
        • Strauss J.
        • Yang G.
        • Giles J.
        • Hu P.
        • Hu Y.
        • Lei X.
        • Park A.
        • Smith J.P.
        • Wang Y.
        China Health and Retirement Longitudinal Study–2011–2012 National Baseline Users' Guide.
        National School of Development, Peking University, Beijing2013: 1-56
        • Zhao Y.
        • Hu Y.
        • Smith J.P.
        • Strauss J.
        • Yang G.
        Cohort profile: the China health and retirement longitudinal study (CHARLS).
        Int. J. Epidemiol. 2012; 43: 61-68
        • Zhao Y.
        • Crimmins E.
        • Hu P.
        • Hu Y.
        • Ge T.
        • Kim J.
        • Strauss J.
        • Yang G.
        • Yin X.
        • Wang Y.
        China Health and Retirement Longitudinal Study–2011–2012 National Baseline Blood Data Users' Guide.
        China Center for Economic Research, Peking University, Beijing2014
        • Joint committee for guideline r
        Chinese guidelines for the management of dyslipidemia in adults.
        J. Geriatr. Cardiol.: JGC. 2016; 15 (2018): 1-29https://doi.org/10.11909/j.issn.1671-5411.2018.01.011
        • Huang Y.
        • Gao L.
        • Xie X.
        • Tan S.C.
        Epidemiology of dyslipidemia in Chinese adults: meta-analysis of prevalence, awareness, treatment, and control.
        Popul. Health Metrics. 2014; 12: 28
        • Deaton A.
        The Analysis of Household Surveys: a Microeconometric Approach to Development Policy.
        The World Bank, 1997
        • Sicular T.
        • Ximing Y.
        • Gustafsson B.
        • Shi L.
        The urban–rural income gap and inequality in China.
        Rev. Income Wealth. 2007; 53: 93-126
        • Yang D.T.
        What has caused regional inequality in China?.
        China Econ. Rev. 2002; 13: 331-334
        • Who E.C.
        Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies.
        Lancet (London, England). 2004; 363: 157
        • Bao Y.
        • Lu J.
        • Wang C.
        • Yang M.
        • Li H.
        • Zhang X.
        • Zhu J.
        • Lu H.
        • Jia W.
        • Xiang K.
        Optimal waist circumference cutoffs for abdominal obesity in Chinese.
        Atherosclerosis. 2008; 201: 378-384
        • Prevention I.
        Standards of medical care in diabetes—2011.
        Diabetes Care. 2011; 34: S11
        • James P.A.
        • Oparil S.
        • Carter B.L.
        • Cushman W.C.
        • Dennison-Himmelfarb C.
        • Handler J.
        • Lackland D.T.
        • LeFevre M.L.
        • MacKenzie T.D.
        • Ogedegbe O.
        evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8).
        Jama. 2014; 311 (2014): 507-520
        • Zhu Y.
        • Pandya B.J.
        • Choi H.K.
        Prevalence of gout and hyperuricemia in the US general population: the national health and nutrition examination survey 2007–2008.
        Arthritis Rheum. 2011; 63: 3136-3141
        • National Bureau of Statistics
        Tabulation on the 2010 Population Census of the People's Republic of China.
        China Statistics Press, Beijing2012
        • Lu Y.
        • Wang P.
        • Zhou T.
        • Lu J.
        • Spatz E.S.
        • Nasir K.
        • Jiang L.
        • Krumholz H.M.
        Comparison of prevalence, awareness, treatment, and control of cardiovascular risk factors in China and the United States.
        J. Am. Heart Assoc. 2018; 7 (JAHA.117.007462)https://doi.org/10.1161/JAHA.117
        • Zhang L.
        • Wang F.
        • Wang L.
        • Wang W.
        • Liu B.
        • Liu J.
        • Chen M.
        • He Q.
        • Liao Y.
        • Yu X.
        Prevalence of chronic kidney disease in China: a cross-sectional survey.
        Lancet. 2012; 379: 815-822
        • Reiner Ž.
        • Sonicki Z.
        • Tedeschi-Reiner E.
        Public perceptions of cardiovascular risk factors in Croatia: the PERCRO survey.
        Prev. Med. 2010; 51: 494-496
        • Protulipac J.M.
        • Sonicki Z.
        • Reiner Ž.
        Cardiovascular disease (CVD) risk factors in older adults–Perception and reality.
        Arch. Gerontol. Geriatr. 2015; 61: 88-92
        • Wang M.
        • Fang H.
        • Bishwajit G.
        • Xiang Y.
        • Fu H.
        • Feng Z.
        Evaluation of rural primary health care in western China: a cross-sectional study.
        Int. J. Environ. Res. Publ. Health. 2015; 12: 13843-13860
        • Kilim S.R.
        • Chandala S.R.
        A comparative study of lipid profile and oestradiol in pre-and post-menopausal women.
        J. Clin. Diagn. Res.: J. Clin. Diagn. Res. 2013; 7: 1596
        • Saha K.
        • Rahman M.
        • Paul A.
        • Das S.
        • Haque S.
        • Jafrin W.
        • Mia A.
        Changes in lipid profile of postmenopausal women.
        Mymensingh Med. J.: MMJ. 2013; 22: 706-711
        • Shohaimi S.
        • Boekholdt M.S.
        • Luben R.
        • Wareham N.J.
        • Khaw K.-T.
        Distribution of lipid parameters according to different socio-economic indicators-the EPIC-Norfolk prospective population study.
        BMC Public Health. 2014; 14: 782
        • Yan-Ling Z.
        • Dong-Qing Z.
        • Chang-Quan H.
        • Bi-Rong D.
        Cigarette smoking and its association with serum lipid/lipoprotein among Chinese nonagenarians/centenarians.
        Lipids Health Dis. 2012; 11: 94
        • e Silva E.R.D.O.
        • Foster D.
        • Harper M.M.
        • Seidman C.E.
        • Smith J.D.
        • Breslow J.L.
        • Brinton E.A.
        Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins AI and A-II.
        Circulation. 2000; 102: 2347-2352
        • Huang S.
        • Li J.
        • Shearer G.C.
        • Lichtenstein A.H.
        • Zheng X.
        • Wu Y.
        • Jin C.
        • Wu S.
        • Gao X.
        Longitudinal study of alcohol consumption and HDL concentrations: a community-based study, 2.
        Am. J. Clin. Nutr. 2017; 105: 905-912
        • Sesso H.D.
        • Stampfer M.J.
        • Rosner B.
        • Hennekens C.H.
        • Manson J.E.
        • Gaziano J.M.
        Seven-year changes in alcohol consumption and subsequent risk of cardiovascular disease in men.
        Arch. Intern. Med. 2000; 160: 2605-2612
        • Emberson J.R.
        • Bennett D.A.
        Effect of alcohol on risk of coronary heart disease and stroke: causality, bias, or a bit of both?.
        Vasc. Health Risk Manag. 2006; 2: 239
        • Wood A.M.
        • Kaptoge S.
        • Butterworth A.S.
        • Willeit P.
        • Warnakula S.
        • Bolton T.
        • Paige E.
        • Paul D.S.
        • Sweeting M.
        • Burgess S.
        Risk thresholds for alcohol consumption: combined analysis of individual-participant data for 599 912 current drinkers in 83 prospective studies.
        Lancet. 2018; 391: 1513-1523