The association between statin-use and diet, exercise, and perceptions of high cholesterol in urban and semi-urban Nigerians: a cross-sectional study.

Abstract

Background The rise of cardiovascular diseases in sub-Saharan Africa strains fragile healthcare systems. Cardiovascular disease prevention involves the use of prophylactic medications like statins and the adoption of healthy lifestyle choices. However, the nature of the relationship between statin-use and the adoption of healthy lifestyle choices remains unclear. This study is the first to examine whether there is a relation between statin-use, the adoption of a low-fat diet and healthy exercise behaviours, and the way Nigerians diagnosed with hyperlipidaemia think about high cholesterol as a risk factor for cardiovascular disease. Methods This cross-sectional study was conducted in an urban site and a semi-urban site in Nigeria. Questionnaires were used to compare the dietary and exercise behaviours; perceptions of high cholesterol; and perceived future risk of cardiovascular disease of 78 statin users and 70 non-statin users. Results The majority (69%) of participants reported that they had adopted a low-fat diet. However, 80% participants were classified as inactive/moderately inactive and statin users were significantly less active than non-statin users (86% of statin users inactive/moderately inactive vs 74% of non-statin users, X2 =3.852, p=0.05). A logistic regression model found that odds of adopting a low-fat diet was 5 times greater in participants recruited from the urban research site (95% CI=1.7 to 12.5, p=0.003) and increased as reported perceived statin control of high cholesterol increased (OR=2.33, 95% CI=1.16 to 4.69, p=0.018). Conclusions The odds of adopting a low-fat diet increased as statin control perceptions increased - suggesting that statin-use and the adoption of healthy dietary choice were thought to work in unison to manage high cholesterol. Urban-dwellers were more likely to have adopted healthy dietary choices and to think about adopting exercise choices than semi-urban dwellers. This demonstrates a growing awareness of negative future impacts of Westernised lifestyle behaviours in urban areas and the need for public health interventions in semi-urban areas to raise awareness and facilitate the adoption of healthy lifestyle choices in order to curtail the rise of cardiovascular disease in Nigeria.