title: Prevalence, awareness, treatment, and control of high low-density lipoprotein cholesterol in Brazil: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
abstract: Dyslipidemia is a pivotal risk factor for coronary heart disease (CHD). The purpose of this study was to identify the profile of dyslipidemia in a Brazilian population, according to high low-density lipoprotein (LDL-C) levels. We used the classification of the 2004 update of National Cholesterol Education Program Adult Treatment Panel III (ATP-III).
  
  
  
  Of the 15,105 men and women aged 35 to 74 years enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we included 14,648 subjects (97%). They had data to categorize them according to the NCEP-ATP-III criteria. We compared 4 categories: "0-1" risk factors, "2 or more risk factors", "CHD or CHD risk equivalent", and "CHD at very high risk". The sociodemographic determinants used were sex, age, ethnicity, income, education, and health insurance. Poisson regression was used to estimate the prevalence ratios for cholesterol (LDL-C), frequency, awareness, treatment, and control of high LDL-C.
  
  
  
  The frequencies of high LDL-C, awareness, treatment, and control were 45.5%, 58.1%, 42.3%, and 58.3%, respectively. After adjustment for sociodemographic determinants, the prevalence ratios for high LDL-C were significantly higher for men, blacks, older subjects, and subjects with lower levels of education. Low frequency of awareness, treatment, and uncontrolled values of LDL-C was observed among men, mixed race and blacks, poorer, less educated, and those who did not have private health insurance.
  
  
  
  The prevalence of high LDL-C was elevated in this Brazilian population, with low rates of awareness, treatment and control, and remarkable socioeconomic disparity.
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil; School of Medicine, Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil. Electronic address: palotufo@usp.br.
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil; School of Medicine, Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil; Heart Institute, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Raul D
authors.initials: RD
authors.lastname: Santos
authors.affiliation: Federal University S.Joao DelRei, Sao Joao DelRei, Brazil; Federal University Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Roberta M
authors.initials: RM
authors.lastname: Figueiredo
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil; Heart Institute, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Pereira
authors.affiliation: Federal University Espirito Santo, Vitoria, Brazil.
authors.forename: Jose Geraldo
authors.initials: JG
authors.lastname: Mill
authors.affiliation: Federal University Bahia, Salvador, Brazil.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Alvim
authors.affiliation: Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: M Jesus
authors.initials: MJ
authors.lastname: Fonseca
authors.affiliation: Federal University Bahia, Salvador, Brazil.
authors.forename: M Conceicão
authors.initials: MC
authors.lastname: Almeida
authors.affiliation: Federal University Espirito Santo, Vitoria, Brazil.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: Molina
authors.affiliation: Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
authors.forename: Dora
authors.initials: D
authors.lastname: Chor
authors.affiliation: Federal University Rio Grande do Sul, Department of Preventive Medicine, Porto Alegra, Brazil.
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
authors.affiliation: Department of Internal Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Ribeiro
authors.affiliation: Federal University Rio Grande do Sul, Department of Preventive Medicine, Porto Alegra, Brazil.
authors.forename: Bruce B
authors.initials: BB
authors.lastname: Duncan
authors.affiliation: Center for Clinical and Epidemiologic Research, Hospital Universitario, University of Sao Paulo, Sao Paulo, Brazil; School of Medicine, Department of Internal Medicine, University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D008078:Cholesterol, LDL
keywords: Cardiovascular; Coronary heart disease; Dyslipidemia; Epidemiology; Risk factors; Statins