Fahey, Tom

Kenny, Rose Anne

Murphy, Catriona

O'Halloran, Aisling

Shelley, Emer

Name not available

Total cholesterol was measured and Low-Density Lipoprotein Cholesterol(LDL-C) was calculated using the Friedewald formula. CVD risk in thosewithout CVD or diabetes was calculated using the Systematic CoronaryRisk Estimation (SCORE) ‘low’ risk country equations.2Hypercholesterolaemia was defined as a LDL-C in excess of therecommended CVD risk category target as outlined in the EuropeanSociety of Cardiology guidelines (Table 1)3 and/or on lipid loweringmedication (LLM).ResultsThe household response rate to the baseline TILDA survey was 62%. Ofthe 8175 adults who participated, 7537 were aged between 50 and 79years. Of these, 70.1% (n=5287) took part in the health assessment andhad complete risk factor data available for analysis. Those excluded fromthe analysis had less favourable risk factor profiles.4Findings reveal a weighted mean TC of 5.1 mmol/L (95% CI 5.0-5.1mmol/L) and a mean LDL-C of 2.9 mmol/L (95% CI 2.8-2.9 mmol/L) inthose aged 50-79 years. LLM was used by 33.9% (95% CI 32.3-35.4%).In those not on LLM the weighted mean TC and LDL-C peaked in menaged 55-59 years and in women aged 60-64 years (Figure 1).IntroductionRaised serum cholesterol is an important modifiable risk factor for thedevelopment of cardiovascular disease (CVD). A reduction in totalcholesterol of 1 mmol/L is associated with a 33% reduction in ischaemicheart disease mortality in those aged 50-69 years and a 17% reduction inthose aged 70-89 years.1The aim of this study is to describe the distribution of serum cholesterol ina community living population of older adults in Ireland aged 50-79 yearsand to examine the awareness, treatment and control ofhypercholesterolaemia in a subgroup aged 50-64 years according to theirCVD risk status.Examination of those with hypercholesterolaemia (n=2357) revealed a varied picture in relation to awareness, treatment and control of LDL-C according to disease status and SCORE risk category (Figure 2). Hypercholesterolaemia in the Irish Adult population: A Cross-Sectional StudyMurphy C 1,2, Shelley E 3, O Halloran A 2, Fahey T 4, Kenny R.A. 21 School of Nursing and Human Sciences, Dublin City University  2 The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin3 Department of Public Health, Health Service Executive  4 HRB Centre for Primary Care Research, Department of General Practice, RCSI, Dublin TILDA is supported by the Department of Health, Irish Life and the Atlantic Philanthropies. This work was funded by the   Health Research Board Ireland under grant number: ICE/2012/7. Conflict of Interest: NoneContact: Dr. Catriona Murphy Catriona.murphy@dcu.ieReferences:1. 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, 1829-39.2. CONROY, R. M., PYÖRÄLÄ, K., FITZGERALD, A. P., SANS, S., MENOTTI, A., DE BACKER, G., DE BACQUER, D., DUCIMETIÈRE, P., JOUSILAHTI, P., KEIL, U., NJØLSTAD, I., OGANOV, R. G., THOMSEN, T., TUNSTALL-PEDOE, H., TVERDAL, A., WEDEL, H., WHINCUP, P., WILHELMSEN, L. & GRAHAM, I. M. 2003. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. European Heart Journal, 24, 987-1003.3. GRAHAM et. al. 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). European Journal of Cardiovascular Prevention and Rehabilitation, 14 Suppl 2, E1-40.4. MURPHY, C., SHELLEY, E., O'HALLORAN, A. M., FAHEY, T. & KENNY, R. A. 2017. Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA). Irish Journal of Medical Science, 186, 1009-1017.5. 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. European Heart Journal, 16, 752-760Figure 2: Awareness treatment and control of hypercholesterolaemia according to cardiovascular disease and SCORE risk stratification (TILDA, wave1, 50-64 years).Figure 1: Weighted mean total cholesterol and LDL cholesterol according to sex, age group and lipid-lowering medication status (TILDA wave 1, 50-79 years, n=5287)ConclusionDespite a substantial reduction in population mean TC from a high of 6.0 mmol/L (aged 35-64 yrs)5 in the 1980s to 5.1 mmol/L, this study reports a failure to control hypercholesterolaemia to recommended CVD risk stratified targets in the Irish adult population. In known high risk groups (CVD or Diabetes) opportunities are being missed to achieve LDL-C control as recommended in clinical guidelines. In the primary prevention category lack of awareness of hypercholesterolaemia was high across all risk stratified groups.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.  MethodsThis study uses nationally representative cross-sectional data from the baseline wave (2009-2011)of the Irish Longitudinal Study on Ageing (TILDA).Home-based interviews and health assessmentswere conducted. Self-report of a doctor’s diagnosisof CVD and diabetes and smoking status wererecorded. Non-fasting blood was drawn and bloodpressure was measured during the healthassessment.Table 1:  LDL-C targets according to disease status or CVD risk 3A high proportion of participants 88.9% (CI 87.8-89.9%) reported ever having a blood test for cholesterol. Almost half of those aged 50-79 years (44.8%, 95% CI 43.3-46.3%) had a TC <5mmol/L and just over half (51.3%, 95% CI 49.8-52.8%) had an LDL-C <3mmol/L.In the subgroup aged 50-64 years (n=3227), 73% (95% CI 71.5-74.5%) were hypercholesterolaemic. 

Hypercholesterolaemia in the Irish adult population: a cross-sectional study

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Hypercholesterolaemia in the Irish adult population: a cross-sectional study

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