Less than one-third of high cholesterol patients in low- and middle-income countries treated

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In 35 low- and middle-income countries, the vast majority of individuals with hi

In 35 low- and middle-income countries, the vast majority of individuals with high cholesterol did not receive adequate care for their condition. The graph shows how many out of all individuals with hypercholesterolemia reach the consecutive care stages, namely what share has been screened for high cholesterol, was aware of their diagnosis, has received advice or medication, and was in control of their high cholesterol. Less than half had been screened for hypercholesterolemia and only one third were aware of their high cholesterol and had received treatment (or medication or lifestyle advice), leaving a large majority without controlled cholesterol levels. Photo: Maja E. Markus

International research team led by Göttingen University finds inadequate care Healthcare in lowand middle-income countries (LMICs) is poorly prepared for the increasing number of individuals with high cholesterol (i.e. hypercholesterolemia). A study on 35 LMICs shows that more than two-thirds of all people affected go without treatment. This was discovered by an international research team led by the University of Göttingen. The study appeared in PLoS Medicine.

An international research team pooled data from 129,040 respondents aged 15 years and above, from 35 nationally representative surveys conducted between 2009 and 2018. The research team then analysed how well health systems meet the care needs of individuals with high cholesterol. First, the researchers determined how many people suffer from high cholesterol. Based on this, they determined how many of these people were screened, diagnosed, treated, and, finally, achieved controlled cholesterol levels.  

Less than half of those affected were previously screened for hypercholesterolemia. Only about one third were aware of their high cholesterol and have received medication or lifestyle for it, leaving a large majority without controlled cholesterol levels. Upper-middle income countries as well as the Americas, the Eastern Mediterranean, and Europe tend to achieve higher care levels. Relatively high performing countries included Sri Lanka and Iran, which may hold important policy lessons for improving hypercholesterolemia care elsewhere.

"High cholesterol is a major risk factor for cardiovascular disease, which is the leading cause of death globally," says Maja Marcus, PhD candidate at the University of Göttingen and first author of the study. "Better care is becoming more affordable with cheaper testing technology, off-patent medication, and free lifestyle advice. More needs to be done to make use of this potential to prevent morbidity and deaths."

Original publication : Maja Marcus et al. (2021): Unmet need for hypercholesterolemia care in 35 lowand middle-income countries: A cross-sectional study of nationally representative surveys. PLoS Medicine 2021. DOI: 10.1371/journal.pmed.1003841

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