Dyslipidemia and Associated Risk Factors in the Elderly Population in Asmara, Eritrea: Results from a Community-Based Cross-Sectional Study

Abstract

Background. The ultimate goal of the study was to approximate the burden and patterns of dyslipidemia in a subset of the elderly population (≥60–85 years) living in Asmara, Eritrea, and to identify modifiable risk drivers. Methods. A total of 319 (145 (45.5%) male vs. 174 (54.5%) female, mean age ± SD (68.06 ± 6.16 years), participants from randomly selected estates within Asmara were enrolled. Demographic and medical information was collected using a standardized questionnaire. Anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) measurements were subsequently taken. Results. The prevalence of dyslipidemia was 70.5%. The proportions of dyslipidemias were (in order of decreasing frequency) high TC (51.2%), LDL-C (43.7%), low HDL-C (28.2%), and TG (27.6%). The average (±SD) concentrations in mg/dL of TC, LDL-C, non-HDL-C, TG, HDL-C, TC/HDL-C, and TG/HDL-C were 202.2 ± 40.63 , 125.95 ± 33.16 , 151.72 ± 37.19 , 129 ± 57.16 , 50.48 ± 10.91 , 4.11 ± 0.91 , and 2.72 ± 1.49 , respectively. Furthermore, 17.5%, 21.6%, 11.0%, and 5.0% had abnormalities in 1, 2, 3, and 4 lipid disorders with the copresence of TC+LDL-C abnormalities dominating. Regarding National Cholesterol Education Program Third Adult Treatment Panel risk strata, 18.5%, 14.5%, 28.2%, and 12.9% were in high or very high-risk categories for TC, LDL-C, TG, and HDL-C, respectively. The high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (43.1%), FPG ≥ 100 mg / dL (16%), hypertension (28.5%), and physical inactivity. Overall, dyslipidemia was associated with sex (females: aOR = 2.6 , 95 % CI = 1.1 – 6.1 , p = 0.017 ) and daily physical activity—higher in individuals undertaking physical activity for <1 hour ( aOR = 2.6 , 95 % CI = 1.1 – 6.1 , p = 0.029 ), 1-2 hours ( aOR = 3.2 , 95 % CI = 1.24 – 8.5 , p = 0.016 ), and 2-3 hours ( aOR = 2.0 , 95 % CI = 0.7 – 5.8 , p = 0.192 ) (Ref: >3 hours). Additional associations included increasing FPG ( aOR = 1.02 , 95 % CI = 1.0 – 1.04 , p = 0.039 ), and BMI ( aOR = 1.19 , 95 % CI = 1.09 – 1.3 , p < 0.001 ). These factors, along with waist circumference (WC), consumption of traditional foods, systolic BP, and diastolic BP, were, with some variations, associated with disparate dyslipidemias. Conclusions. The burden of dyslipidemia in the elderly population in Asmara is high. Modifiable risk drivers included FPG, WC, physical inactivity, and low consumption of traditional food. Overall, efforts directed at scaling up early recognition and treatment, including optimal pharmacological and nonpharmacological therapy, at all levels of care, should be instituted.

Risk Analysis and Assessment of Lipid Abnormalities as the Earliest Complication in Newly Diagnosed Diabetic and Non-Diabetic Individuals of a Local Population

“…Our study shows a higher proportion of reduced HDL in both the included group participants as compared to the findings of the study, revealing higher TGs (58%) in subjects with type 2 diabetes [ 29 ]. Contrary to our findings, another study demonstrated high TC (51.2%) as compared to HDL (28.2%) and TGs (27.6%) among the subjects [ 30 ]. Diet and lifestyle play a key role in affecting health status.…”

A community based cross sectional study on the prevalence of dyslipidemias and 10 years cardiovascular risk scores in adults in Asmara, Eritrea

“…On the basis of currently available data, we believe that a large part of the observed outcome can be explained by physical inactivity and dietary factors. In general, Eritrea's traditional cuisine is starch- rich and emerging evidence supports the notion that sedentarism is a problem in Asmara 18 . Research in runners and the Framingham study demonstrated a strong inverse relationship between HDL-C concentration and physical activity 48 .…”

“…“A single population-proportion formula was used to determine the sample size 17 .” Using a proportion of dyslipidemia to be 70% (we used 70% prevalence) 18 , 95% confidence interval (CI), 5% type I error level, 80% power, and design effect of 1.2; the sample size was calculated to be close to 386 participants.…”

Determinants of Cardiovascular Diseases in the Elderly Population in Indonesia: Evidence from Population-Based Indonesian Family Life Survey (IFLS)

“…Previous studies stated that elderly people with dyslipidemia were at increased risk of CVD events. 30 , 31 Hypercholesterolemia increases the atherosclerosis process leading to the deposition of cholesterol and fatty acids in artery walls, making it at risk for the development of CVD. 32 …”

“…Previous studies stated that elderly people with dyslipidemia were at increased risk of CVD events. 30,31 Hypercholesterolemia increases the atherosclerosis process leading to the deposition of cholesterol and fatty acids in artery walls, making it at risk for the development of CVD. 32 Our findings highlight the need for policymakers and healthcare providers to develop tailored interventions targeted at the elderly population.…”