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Published in: Irish Journal of Medical Science (1971 -) 4/2017

Open Access 01-11-2017 | Original Article

Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA)

Authors: C. Murphy, E. Shelley, A. M. O’Halloran, T. Fahey, R. A. Kenny

Published in: Irish Journal of Medical Science (1971 -) | Issue 4/2017

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Abstract

Background

Hypercholesterolaemia is an important modifiable risk factor for cardiovascular disease (CVD) which requires monitoring and management at a population level.

Aims

This study aims to describe the distribution of serum cholesterol in a community living population of older adults in Ireland and to examine the awareness, treatment and control of hypercholesterolaemia according to CVD risk status.

Method

This is a cross-sectional study in a nationally representative sample of adults aged 50–79 years (n = 5287). Hypercholesterolaemia was defined as low-density lipoprotein cholesterol (LDL-C) in excess of the recommended CVD risk category target and/or on lipid-lowering medication.

Results

This study reports a mean total cholesterol (TC) of 5.1 mmol/L (95% CI 5.0–5.1 mmol/L) and a mean LDL-C of 2.9 mmol/L (95% CI 2.8–2.9 mmol/L) in those aged 50–79 years. In a subgroup aged 50–64 years, 73% (95% CI 71.5–74.5%) were hypercholesterolaemic. LDL-C was controlled to the guideline target in 57% of those with CVD and 49% of those with diabetes. Lack of awareness of hypercholesterolaemia was high across the remainder of the population.

Conclusion

Despite a substantial reduction in population mean TC from a high of 6.0 mmol/L in the 1980s to 5.1 mmol/L, this study reports a failure to control hypercholesterolaemia to recommended risk-stratified targets in the Irish adult population. Recommendations for policy include continued monitoring of those at highest risk and CVD risk assessment in those perceived to be at low risk in order to inform shared decision making in relation to lifestyle modification and medication management.
Literature
2.
go back to reference Central Statistics Office (2013) Vital statistics and fourth quarter and yearly summary 2012. Central Statistics Office, Stationery Office, Dublin Central Statistics Office (2013) Vital statistics and fourth quarter and yearly summary 2012. Central Statistics Office, Stationery Office, Dublin
3.
go back to reference Kabir Z, Perry I, Critchley J, O’Flaherty M, Capewell S, Bennett K (2013) Modelling coronary heart disease mortality declines in the Republic of Ireland 1985–2006. Int J Cardiol 168(3):2462–2467CrossRefPubMed Kabir Z, Perry I, Critchley J, O’Flaherty M, Capewell S, Bennett K (2013) Modelling coronary heart disease mortality declines in the Republic of Ireland 1985–2006. Int J Cardiol 168(3):2462–2467CrossRefPubMed
4.
go back to reference Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, Qizilbash N, Peto R, Collins R (2007) Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 370(9602):1829–1839. doi:10.1016/s0140-6736(07)61778-4 CrossRefPubMed Lewington S, Whitlock G, Clarke R, Sherliker P, Emberson J, Halsey J, Qizilbash N, Peto R, Collins R (2007) Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet 370(9602):1829–1839. doi:10.​1016/​s0140-6736(07)61778-4 CrossRefPubMed
5.
go back to reference Muntner P, Levitan EB, Brown TM, Sharma P, Zhao H, Bittner V, Glasser S, Kilgore M, Yun H, Woolley JM, Farkouh ME, Rosenson RS (2013) Trends in the prevalence, awareness, treatment and control of high low density lipoprotein-cholesterol among United States adults from 1999–2000 through 2009–2010. Am J Cardiol 112(5):664–670. doi:10.1016/j.amjcard.2013.04.041 CrossRefPubMedPubMedCentral Muntner P, Levitan EB, Brown TM, Sharma P, Zhao H, Bittner V, Glasser S, Kilgore M, Yun H, Woolley JM, Farkouh ME, Rosenson RS (2013) Trends in the prevalence, awareness, treatment and control of high low density lipoprotein-cholesterol among United States adults from 1999–2000 through 2009–2010. Am J Cardiol 112(5):664–670. doi:10.​1016/​j.​amjcard.​2013.​04.​041 CrossRefPubMedPubMedCentral
7.
go back to reference Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, Ezzati M (2011) National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 377(9765):578–586. doi:10.1016/s0140-6736(10)62038-7 CrossRefPubMed Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, Ezzati M (2011) National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Lancet 377(9765):578–586. doi:10.​1016/​s0140-6736(10)62038-7 CrossRefPubMed
9.
go back to reference Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen ML, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgozoglu L, Wiklund O, Zampelas A (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 14(Suppl 2):E1–40. doi:10.1097/01.hjr.0000277984.31558.c4 Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Op Reimer WS, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Funck-Brentano C, Filippatos G, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Altiner A, Bonora E, Durrington PN, Fagard R, Giampaoli S, Hemingway H, Hakansson J, Kjeldsen SE, Larsen ML, Mancia G, Manolis AJ, Orth-Gomer K, Pedersen T, Rayner M, Ryden L, Sammut M, Schneiderman N, Stalenhoef AF, Tokgozoglu L, Wiklund O, Zampelas A (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 14(Suppl 2):E1–40. doi:10.​1097/​01.​hjr.​0000277984.​31558.​c4
10.
go back to reference Whelan BJ (1979) RANSAM: a national random sampling design for Ireland. Econ Soc Rev 10(2):169–174 Whelan BJ (1979) RANSAM: a national random sampling design for Ireland. Econ Soc Rev 10(2):169–174
11.
go back to reference Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003. doi:10.1016/s0195-668x(03)00114-3 CrossRefPubMed Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM (2003) Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 24(11):987–1003. doi:10.​1016/​s0195-668x(03)00114-3 CrossRefPubMed
12.
go back to reference Kenny RA, Whelan B, Cronin H, Kamiya Y, Kearney P, O’Regan C (2010) The design of The Irish Longitudinal Study on Ageing. The Irish Longitudinal Study on Ageing, Trinity College, Dublin Kenny RA, Whelan B, Cronin H, Kamiya Y, Kearney P, O’Regan C (2010) The design of The Irish Longitudinal Study on Ageing. The Irish Longitudinal Study on Ageing, Trinity College, Dublin
14.
go back to reference Richardson K, Kenny RA, Peklar J, Bennett K (2013) Agreement between patient interview data on prescription medication use and pharmacy records in those aged older than 50 years varied by therapeutic group and reporting of indicated health conditions. J Clin Epidemiol 66(11):1308–1316. doi:10.1016/j.jclinepi.2013.02.016 CrossRefPubMed Richardson K, Kenny RA, Peklar J, Bennett K (2013) Agreement between patient interview data on prescription medication use and pharmacy records in those aged older than 50 years varied by therapeutic group and reporting of indicated health conditions. J Clin Epidemiol 66(11):1308–1316. doi:10.​1016/​j.​jclinepi.​2013.​02.​016 CrossRefPubMed
15.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund ULF, Yngve A, Sallis JF, Oja P (2003) International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395CrossRefPubMed Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund ULF, Yngve A, Sallis JF, Oja P (2003) International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395CrossRefPubMed
16.
go back to reference Department of Health and Children (2010) Changing Cardiovascular Health National Cardiovascular Health Policy 2010–2019. Department of Health and Children, Dublin Department of Health and Children (2010) Changing Cardiovascular Health National Cardiovascular Health Policy 2010–2019. Department of Health and Children, Dublin
18.
go back to reference NHS The information centre for health and social care (2011) Health Survey for England 2011 Health, social care and lifestyles, Summary of key findings. Department of Health, London NHS The information centre for health and social care (2011) Health Survey for England 2011 Health, social care and lifestyles, Summary of key findings. Department of Health, London
19.
go back to reference Oyebode O (2012) Health Survey for Engand-2011, Health, social care and lifestyles. Chapter 2: cardiovascular disease. The Information Centre for Health and Social Care, NHS, London Oyebode O (2012) Health Survey for Engand-2011, Health, social care and lifestyles. Chapter 2: cardiovascular disease. The Information Centre for Health and Social Care, NHS, London
20.
go back to reference Ferrieres J, Bongard V, Dallongeville J, Arveiler D, Cottel D, Haas B, Wagner A, Amouyel P, Ruidavets JB (2009) Trends in plasma lipids, lipoproteins and dyslipidaemias in French adults, 1996–2007. Arch Cardiovasc Dis 102(4):293–301. doi:10.1016/j.acvd.2009.02.002 CrossRefPubMed Ferrieres J, Bongard V, Dallongeville J, Arveiler D, Cottel D, Haas B, Wagner A, Amouyel P, Ruidavets JB (2009) Trends in plasma lipids, lipoproteins and dyslipidaemias in French adults, 1996–2007. Arch Cardiovasc Dis 102(4):293–301. doi:10.​1016/​j.​acvd.​2009.​02.​002 CrossRefPubMed
22.
go back to reference Shelley E, Daly L, Collins C, Christie M, Conroy R, Gibney M, Hickey N, Kelleher C, Kilcoyne D, Lee P, Mulcahy R, Murray P, O’Dwyer T, Radic A, Graham I (1995) Cardiovascular risk factor changes in the Kilkenny Health Project: a community health promotion programme. Eur Heart J 16(6):752–760CrossRefPubMed Shelley E, Daly L, Collins C, Christie M, Conroy R, Gibney M, Hickey N, Kelleher C, Kilcoyne D, Lee P, Mulcahy R, Murray P, O’Dwyer T, Radic A, Graham I (1995) Cardiovascular risk factor changes in the Kilkenny Health Project: a community health promotion programme. Eur Heart J 16(6):752–760CrossRefPubMed
23.
go back to reference Eriksson M, Forslund AS, Jansson JH, Soderberg S, Wennberg M, Eliasson M (2016) Greater decreases in cholesterol levels among individuals with high cardiovascular risk than among the general population: the northern Sweden MONICA study 1994 to 2014. Eur Heart J 37(25):1985–1992. doi:10.1093/eurheartj/ehw052 CrossRefPubMedPubMedCentral Eriksson M, Forslund AS, Jansson JH, Soderberg S, Wennberg M, Eliasson M (2016) Greater decreases in cholesterol levels among individuals with high cardiovascular risk than among the general population: the northern Sweden MONICA study 1994 to 2014. Eur Heart J 37(25):1985–1992. doi:10.​1093/​eurheartj/​ehw052 CrossRefPubMedPubMedCentral
24.
go back to reference Morgan K, McGee H, Watson D, Perry I, Barry M, Shelley E, Harrington J, Molcho M, Layte R, Tully N, van Lente E, Ward M, Lutmski J, Conroy R, Brugha R (2007) SLÁN 2007: survey of lifestyle, attitudes & nutrition in Ireland. Main report. Department of Health and Children, Dublin Morgan K, McGee H, Watson D, Perry I, Barry M, Shelley E, Harrington J, Molcho M, Layte R, Tully N, van Lente E, Ward M, Lutmski J, Conroy R, Brugha R (2007) SLÁN 2007: survey of lifestyle, attitudes & nutrition in Ireland. Main report. Department of Health and Children, Dublin
25.
go back to reference Gu Q, Paulose-Ram R, Burt VL, Kit B (2014) Prescription cholesterol-lowering medication use in adults aged 40 and over: United States, 2003–2012. NCHS Data Brief No 177 Gu Q, Paulose-Ram R, Burt VL, Kit B (2014) Prescription cholesterol-lowering medication use in adults aged 40 and over: United States, 2003–2012. NCHS Data Brief No 177
26.
go back to reference Horgan S, Crowley J, Feely J, McAdam B, Shanahan E, Vaughan C (2011) Prevalence of dyslipidaemia in statin-treated patients in Ireland: Irish results of the DYSlipidaemia International Study (DYSIS). Ir J Med Sci 180(2):343–349. doi:10.1007/s11845-011-0702-8 CrossRefPubMed Horgan S, Crowley J, Feely J, McAdam B, Shanahan E, Vaughan C (2011) Prevalence of dyslipidaemia in statin-treated patients in Ireland: Irish results of the DYSlipidaemia International Study (DYSIS). Ir J Med Sci 180(2):343–349. doi:10.​1007/​s11845-011-0702-8 CrossRefPubMed
27.
go back to reference Usher-Smith JA, Silarova B, Schuit E, Moons KG, Griffin SJ (2015) Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review. BMJ Open 5(10). doi:10.1136/bmjopen-2015-008717 Usher-Smith JA, Silarova B, Schuit E, Moons KG, Griffin SJ (2015) Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review. BMJ Open 5(10). doi:10.​1136/​bmjopen-2015-008717
28.
go back to reference Byrne D, O’Connor L, Jennings S, Bennett K, Murphy AW (2015) A survey of GPs awareness and use of risk assessment tools and cardiovascular disease prevention guidelines. Ir Med J 108(7):204–207PubMed Byrne D, O’Connor L, Jennings S, Bennett K, Murphy AW (2015) A survey of GPs awareness and use of risk assessment tools and cardiovascular disease prevention guidelines. Ir Med J 108(7):204–207PubMed
29.
go back to reference Usher-Smith JA, Pritchard J, Poole S, Griffin SJ (2015) Offering statins to a population attending health checks with a 10-year cardiovascular disease risk between 10% and 20%. Int J Clin Pract 69(12):1457–1464. doi:10.1111/ijcp.12742 CrossRefPubMed Usher-Smith JA, Pritchard J, Poole S, Griffin SJ (2015) Offering statins to a population attending health checks with a 10-year cardiovascular disease risk between 10% and 20%. Int J Clin Pract 69(12):1457–1464. doi:10.​1111/​ijcp.​12742 CrossRefPubMed
31.
go back to reference Khanji MY, Bicalho VS, van Waardhuizen CN, Ferket BS, Petersen SE, Hunink M (2016) Cardiovascular risk assessment: a systematic review of guidelines. Ann Intern Med. doi:10.7326/M16-1110 PubMed Khanji MY, Bicalho VS, van Waardhuizen CN, Ferket BS, Petersen SE, Hunink M (2016) Cardiovascular risk assessment: a systematic review of guidelines. Ann Intern Med. doi:10.​7326/​M16-1110 PubMed
Metadata
Title
Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA)
Authors
C. Murphy
E. Shelley
A. M. O’Halloran
T. Fahey
R. A. Kenny
Publication date
01-11-2017
Publisher
Springer London
Published in
Irish Journal of Medical Science (1971 -) / Issue 4/2017
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-017-1590-3

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