Abstract
Background
The most recent Canadian population-level data on lipid levels are from 1992. This study presents current estimates of Canadians with dyslipidemia, the proportion aware of their condition, and the proportion being treated and below target values.
Methods
The Canadian Health Measures Survey (2007–2009) assessed the prevalence, awareness and treatment of dyslipidemia. Dyslipidemia was defined as TC/HDL-C ratio ≥5; measured LDL-C ≥3.5 mmol/L; or taking lipid-modifying medications. The 2009 guidelines for the diagnosis and treatment of dyslipidemia were used to define low, moderate or high cardiovascular disease (CVD) risk and treatment initiation and targets.
Results
Forty-five percent of Canadians aged 18–79 years have dyslipidemia. Fifty-seven percent of respondents were not aware of their condition. Lipid-modifying therapy was initiated in individuals where treatment would be recommended in 49%, 20% and 54% of those at high, moderate, and low risk levels, respectively. The majority (81%) of those taking medication had their lipid levels under desirable levels, however, only 24% of those with dyslipidemia reported medication use. Overall, only 19% of those with dyslipidemia had their lipids under recommended levels. Only 41% of those taking lipid-modifying medication reached a recommended target of LDL-C <2 mmol/L or ApoB <0.8 g/L.
Conclusion
There is still a high proportion of Canadians at high risk of CVD, with dyslipidemia, who are not being treated to recommended levels. These data need to be integrated into CVD reduction recommendations and represent an important baseline for assessing progress.
Key Words: Dyslipidemias, population, health surveys, guidelines, Canada
Résumé
Contexte
Les plus récentes données en population sur les niveaux de lipides au Canada datent de 1992. Notre étude présente les estimations actuelles sur les Canadiens ayant une dyslipidémie, la proportion de gens connaissant leur état et la proportion traitée pour une dyslipidémie, mais présentant des valeurs sous-optimales.
Méthode
L’Enquête canadienne sur les mesures de la santé (2007–2009) a évalué la prévalence, la connaissance et le traitement des dyslipidémies. Une dyslipidémie était définie ainsi: ratio CT/HDLc ≥ 5; LDLc mesuré ≥ 3,5 mmol/L; ou prise de médicaments hypolipémiants. Nous avons utilisé les directives de 2009 pour le diagnostic et le traitement des dyslipidémies pour définir le risque de maladie cardiovasculaire (MCV) - faible, modéré ou élevé - ainsi que l’instauration du traitement et les valeurs cibles du traitement.
Résultats
Quarante-cinq p. cent des Canadiens de 18 à 79 ans ont une dyslipidémie. Cinquante-sept p. cent des répondants n’étaient pas conscients de leur état. Des traitements hypolipémiants avaient été instaurés, dans les cas où ces traitements étaient recommandés, chez 49 %, 20 % et 54 % respectivement des sujets présentant un niveau de risque élevé, modéré et faible. La majorité (81 %) des sujets prenant des médicaments avaient des niveaux de lipides sous-optimaux, mais seulement 24 % des sujets ayant une dyslipidémie disaient prendre des médicaments. Globalement, seulement 19 % des sujets ayant une dyslipidémie avaient des niveaux de lipides sous les niveaux recommandés. Seulement 41 % des sujets prenant des hypolipémiants atteignaient la cible recommandée (LDLc <2 mmol/L ou Apo B <0,8 g/L).
Conclusion
Il y a encore une proportion élevée de Canadiens présentant un risque élevé de MCV, avec dyslipidémie, qui ne sont pas traités selon les niveaux recommandés. Ces données devraient être intégrées dans les recommandations sur la réduction des MCV; elles représentent aussi une importante base de référence pour évaluer les progrès.
Mots Clés: dyslipidémies, population, enquêtes de santé, directives, Canada
Footnotes
Conflict of Interest: None to declare.
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