Awareness, treatment, control, and determinants of dyslipidemia among adults in China: results from the China National Stroke Screening and Prevention Project (CNSSPP)

Abstract

Background:Effective management of dyslipidemia could play a vital role in the control of cardiovascular diseases. This study aimed to determine the awareness, treatment, control, and determinants of dyslipidemia in middle-aged and older Chinese adults in China. METHODS Using data from the 2015 CNSSPP, a nationally representative sample of 135,403 Chinese adults aged over 40 years were included in the cross-sectional analysis. Dyslipidemia was defined according to the 2016 Chinese guidelines for the management of dyslipidemia in adults. Models were constructed to adjust for sociodemographic, clinical and behavioral characteristics with bivariate and multivariable logistic regressions. RESULTSOverall, 51.1% of the subjects were women. Sixty-four percent (36,958/57760) were aware of their condition, of whom 18.9% (6993/36958) received treatment, and of whom 7.3 % (504 /6993) had controlled lipids. Women versus men had higher proportions of awareness, treatment, and control (69.2% vs. 58.3%, 63.8% vs.64.1% and 7.7% vs.7.0%; p< 0.001), respectively. Dyslipidemia treatment was higher in men from rural than urban areas (15.4% vs. 10.6%; p<0.001). Most subjects (94.3%), had dyslipidemia in their family. The proportion of awareness was higher among urban compared to rural residents across all the socioeconomic regions: low-income (68.8% vs. 60.4%), middle-income (69.4% vs.63.9%), and high-income (66% vs.58.6%), respectively (all p< 0.001). In the multivariable analysis, significant associations were found between awareness and women, urban residents, having a family history, and central obesity. Being a woman, having a personal history of stroke or CHD, being a drinker, having health insurance, and persons who lived in high-income regions had higher odds of receiving treatment. Adults in the 50 - 59 years age group, having health insurance, central and general obesity, living in a stroke belt or northern zone, urban area, and women showed statistically significant relationships with control. CONCLUSIONS Dyslipidemia awareness was moderately high, but treatment and control were low. Improvements in education programs and therapeutic management may be necessary to promote and optimize the management of dyslipidemia.