title: Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA).
abstract: BACKGROUND
  Hypercholesterolaemia is an important modifiable risk factor for cardiovascular disease (CVD) which requires monitoring and management at a population level.
  
  
  OBJECTIVE
  This study aims to describe the distribution of serum cholesterol in a community living population of older adults in Ireland and to examine the awareness, treatment and control of hypercholesterolaemia according to CVD risk status.
  
  
  METHODS
  This is a cross-sectional study in a nationally representative sample of adults aged 50-79 years (n = 5287). Hypercholesterolaemia was defined as low-density lipoprotein cholesterol (LDL-C) in excess of the recommended CVD risk category target and/or on lipid-lowering medication.
  
  
  RESULTS
  This study reports a mean total cholesterol (TC) of 5.1 mmol/L (95% CI 5.0-5.1 mmol/L) and a mean LDL-C of 2.9 mmol/L (95% CI 2.8-2.9 mmol/L) in those aged 50-79 years. In a subgroup aged 50-64 years, 73% (95% CI 71.5-74.5%) were hypercholesterolaemic. LDL-C was controlled to the guideline target in 57% of those with CVD and 49% of those with diabetes. Lack of awareness of hypercholesterolaemia was high across the remainder of the population.
  
  
  CONCLUSIONS
  Despite a substantial reduction in population mean TC from a high of 6.0 mmol/L in the 1980s to 5.1 mmol/L, this study reports a failure to control hypercholesterolaemia to recommended risk-stratified targets in the Irish adult population. Recommendations for policy include continued monitoring of those at highest risk and CVD risk assessment in those perceived to be at low risk in order to inform shared decision making in relation to lifestyle modification and medication management.
authors.affiliation: School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland. catriona.murphy@dcu.ie.|The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College, Dublin, Ireland. catriona.murphy@dcu.ie.
authors.forename: C
authors.initials: C
authors.lastname: Murphy
authors.affiliation: Department of Public Health, Health Service Executive, Dublin, Ireland.
authors.forename: E
authors.initials: E
authors.lastname: Shelley
authors.affiliation: The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: A M
authors.initials: AM
authors.lastname: O'Halloran
authors.affiliation: HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland Medical School, Dublin, Ireland.
authors.forename: T
authors.initials: T
authors.lastname: Fahey
authors.affiliation: The Irish Longitudinal Study on Ageing (TILDA), Department of Medical Gerontology, Trinity College, Dublin, Ireland.
authors.forename: R A
authors.initials: RA
authors.lastname: Kenny
mesh_terms: D000368:Aged; D000375:Aging; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000188:drug therapy*; D007494:Ireland; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
keywords: CVD risk; Cardiovascular disease; Dyslipidaemia; Hypercholesterolaemia; Older adults