title: Prevalence and control of hypercholesterolaemia as defined by NCEP-ATPIII guidelines and predictors of LDL-C goal attainment in a multi-ethnic Asian population.
abstract: BACKGROUND
  Few studies in Asia have assessed the burden of hypercholesterolaemia based on the global cardiovascular risk assessment. This study determines the burden of hypercholesterolaemia in an Asian population based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) guidelines, and examines predictors of low-density lipoprotein cholesterol (LDL-C) goal attainment.
  
  
  METHODS
  Five thousand and eighty-three Chinese, Malays and Asian-Indians living in Singapore were assigned to coronary heart disease (CHD)-risk category based on the NCEP-ATPIII guidelines. Awareness, treatment and control of hypercholesterolaemia based on risk- specific LDL-C goal were determined, including the use of lipid-lowering therapy (LLT). Cox-regression models were used to identify predictors of LDL-C above goal among those who were aware and unaware of hypercholesterolaemia.
  
  
  RESULTS
  One thousand five hundred and sixty-eight (30.8%) participants were aware of hypercholesterolaemia and 877 (17.3%) were newly diagnosed (unaware). For those who were aware, 39.3% participants received LLT. Among those with 2 risk factors, only 59.7% attained LDL-C goal. The majority of them were taking statin monotherapy, and the median dose of statins was similar across all CHD risk categories. Among participants with 2 risk factors and not receiving LLT, 34.1% would require LLT. Malays or Asian-Indians, higher CHD risk category, increasing body mass index (BMI), current smoking and lower education status were associated with higher risk of LDL-C above goal. Being on LLT reduced the risk of having LDL-C above goal.
  
  
  CONCLUSIONS
  The burden of hypercholesterolaemia is high in this multi-ethnic population especially those in the higher CHD risk categories, and might be partly contributed by inadequate titration of statins therapy. Raising awareness of hypercholesterolaemia, appropriate LLT initiation and titration, weight management and smoking cessation may improve LDL-C goal attainment in this population.
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.
authors.forename: Chin Meng
authors.initials: CM
authors.lastname: Khoo
authors.forename: Maudrene L S
authors.initials: ML
authors.lastname: Tan
authors.forename: Yi
authors.initials: Y
authors.lastname: Wu
authors.forename: Daniel C H
authors.initials: DC
authors.lastname: Wai
authors.forename: Tavintharan
authors.initials: T
authors.lastname: Subramaniam
authors.forename: E Shyong
authors.initials: ES
authors.lastname: Tai
authors.forename: Jeannette
authors.initials: J
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012846:Singapore / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL