Failure to control hypercholesterolaemia in the Irish adult population: cross-sectional analysis of the baseline wave of The Irish Longitudinal Study on Ageing (TILDA)

Background. Hypercholesterolaemia is an important modifiable risk factor for cardiovascular disease (CVD) which requires monitoring and management at a population level. Aims. 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. Method. This is a cross-sectional study in a nationally representative sample of adults aged 50–79 years (n = 5287). Hypercholesterolaemia was defined as lowdensity lipoprotein cholesterol (LDL-C) in excess of the recommended CVD risk category target and/or on lipidlowering 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. Conclusion. 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.