NATIONAL PREVALENCE OF HYPERCHOLESTEROLEMIA, TREATMENT AND CONTROL, IN FRANCE IN 2015 AND TEMPORAL TRENDS SINCE 2006

Abstract

<ST>Objective:</ST> The aims of this public-funded and representative study were to assess prevalence diagnosis, treatment and control of hypercholesterolemia LDL in the adult population in France in 2015 and to describe temporal trends between 2006 and 2015. <ST>Design and method:</ST> The Esteban survey is a cross-sectional survey based on a multistage sampling design and conducted in continental France in 2015–2016. The design was the same as the one of the 2006-survey. Both samples were representative of the French adult population (18–74 years). Lipids concentrations were measured in a national sample of non-institutionalized adults during a health examination. LDL-cholesterol (LDLc) was determined by the Friedewald equation only if triglycerides were lower than 3.4 g/l. Sociodemographic characteristics and risk factors were collected by questionnaires. Lipid-lowering treatments during the year preceding the survey came from the reimbursement databases of the national health insurance inter-scheme information system. Hypercholesterolemia LDL was defined as LDLc greater than 1.6 g/l, or a reimbursement for lipid-lowering drugs. Analyses were weighted and adjusted. <ST>Results:</ST> LDLc was determined in 2,074 adults (44.8% of men). The mean LDLc was 1.30 g/l (CI95% [1.28–1.32]). One adult in five had LDLc >1.6 g/l and 8.8% had a reimbursement for lipid-lowering drugs (statins: 7.5%). The prevalence of hypercholesterolemia LDL was 27.0% [24.5–29.5] and increased with age, reaching 48.4% in adults aged 65–74 years, and was higher in men (29.7%) than in women (24.5%). Between 2006 and 2015, mean LDLc and the proportion of adults with a LDLc >1.6 g/l were stable (p = 0.5 and p = 0.09, respectively). We observed a 18% decrease in the prevalence of hypercholesterolemia LDL (p < 0.001) and a 33% decrease in the proportion of adults having a reimbursement for lipid-lowering drugs (p < 0.0001). <ST>Conclusions:</ST> Despite a significant decrease in the prevalence of hypercholesterolemia LDL observed during the past decade, it remains high in France. Our study suggested that this decrease could be linked to changes in the lipid-lowering drugs prescription. Further analyses are necessary to investigate this hypothesis.