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IJE Advance Access published online on August 27, 2004

International Journal of Epidemiology, doi:10.1093/ije/dyi056
© 2004 by International Epidemiological Association
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IJE © International Epidemiological Association 2004; all rights reserved.
Accepted June 30, 2004

Original paper

Prevalence, awareness and treatment of hypercholesterolaemia in 32 populations: results from the WHO MONICA Project

Hanna Tolonen 1*, Ulrich Keil 2, Marco Ferrario 3, Alun Evans 4, and for the WHO MONICA Project 5

1 Department of Epidemiology and Health Promotion, National Public Health Institute (KTL), Helsinki, Finland
2 Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
3 Department of Clinical and Biologic Sciences, University of Insubria, Varese, Italy
4 Department of Epidemiology and Public Health, Queen's University Belfast, UK
5 Appendix: Sites and key personnel of the WHO MONICA Project

* To whom correspondence should be addressed.
Hanna Tolonen, E-mail: hanna.tolonen{at}ktl.fi


   Abstract

Background Several studies have been conducted to estimate the population prevalence of hypertension, or its diagnosis and treatment. There is no multinationally comparable information on the prevalence of hypercholesterolaemia, or its diagnosis and treatment, since individual studies are often not directly comparable.

Methods Data from the WHO MONICA Project's final risk factor surveys were used. Data were collected using standardized methods between 1989 and 1997 for the 35-64 year age range in 32 populations, in 19 countries on 3 continents.

Results The prevalence of hypercholesterolaemia (total cholesterol ≥6.5 mmol/l or taking lipid-lowering drugs) varied across populations from 3% to 53% in men, and from 4% to 40% in women. Awareness of hypercholesterolaemia varied from 1% to 33% in men, and from 0% to 31% in women. In most populations, over 50% of men and women on lipid-lowering drugs had a cholesterol level ≤6.5 mmol/l.

Conclusions There is wide variation in the prevalence, awareness, and treatment of hypercholesterolaemia between populations. For the planning and implementation of primary prevention programmes and for the development of health care systems, monitoring of changes, both within and between populations, is essential. To obtain reliable information on these changes, well-standardized methods must be applied.

Keywords: Prevalence; awareness; treatment; cholesterol; population study; standardization.
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