Prevalence and distributions of severely elevated low-density lipoprotein cholesterol (LDL-c) according to age, gender and clinic location among patients in the Malaysian primary care

Kanchau, Johanes Dedi; Akyea, Ralph Kwame; Baharudin, Noorhida; Mohamed-Yassin, Mohamed-Syarif; Kamal, Aisyah; Chua, Yung-An; Razman, Aimi Zafira; Abdul-Hamid, Hasidah; Abdul-Razak, Suraya; Badlishah-Sham, Siti Fatimah; Abdul Aziz, Aznida Firzah; Qureshi, Nadeem; Ramli, Anis Safura

Abstract

Background
Adults with severely elevated low-density lipoprotein cholesterol (LDL-c) may have familial hypercholesterolaemia (FH) and are at high risk of atherosclerotic cardiovascular disease (ASCVD). The prevalence of elevated LDL-c in primary care clinics in Malaysia is not known. Therefore, this study aimed to determine the prevalence and distributions of severely elevated LDL-c among adult patients attending public primary care clinics in Malaysia.
Methods
A cross-sectional study was conducted at 11 public primary care clinics in the central states of Malaysia, among adults ≥18 years old with LDL-c recorded in the electronic medical record. Sociodemographic and LDL-c data from 2018 to 2020 were extracted. Severely elevated LDL-c was defined as ≥4 mmol/L, which were further classified into: 4.0–4.9, 5.0–5.9, 6.0–6.9 and ≥ 7 mmol/L.
Results
Out of 139,702 patients, 44,374 (31.8 %) had severely elevated LDL-c of ≥4 mmol/L of which the majority were females (56.7 %). The mean (±SD) age of patients with severely elevated LDL-c was younger at 56.3 (±13.2) years compared to those with LDL-c of <4.0 mmol/L at 59.3 (±14.5) years. In terms of LDL-c levels, 30,751 (69.3 %), 10,412 (23.5 %), 2,499 (5.6 %) and 712 (1.6 %) were in the 4.0–4.9, 5.0–5.9, 6.0–6.9 and ≥ 7 mmol/L categories, respectively.
Conclusion
The prevalence of severely elevated LDL-c of ≥4.0 mmol/L among adult patients in public primary care clinics was high. These patients need to be further investigated for secondary and inherited causes such as FH. Therapeutic lifestyle modification and pharmacological management are pivotal to prevent ASCVD in these patients.

Citation

Kanchau, J. D., Akyea, R. K., Baharudin, N., Mohamed-Yassin, M.-S., Kamal, A., Chua, Y.-A., Razman, A. Z., Abdul-Hamid, H., Abdul-Razak, S., Badlishah-Sham, S. F., Abdul Aziz, A. F., Qureshi, N., & Ramli, A. S. (2024). Prevalence and distributions of severely elevated low-density lipoprotein cholesterol (LDL-c) according to age, gender and clinic location among patients in the Malaysian primary care. Clinical Epidemiology and Global Health, 27, Article 101619. https://doi.org/10.1016/j.cegh.2024.101619

• Journal Article Type: Article
• Acceptance Date: Apr 23, 2024
• Online Publication Date: May 2, 2024
• Publication Date: 2024-05
• Deposit Date: May 9, 2024
• Publicly Available Date: May 9, 2024
• Journal: Clinical Epidemiology and Global Health
• Print ISSN: 2213-3984
• Electronic ISSN: 2213-3984
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Article Number: 101619
• DOI: https://doi.org/10.1016/j.cegh.2024.101619
• Keywords: hypercholesterolaemia; dyslipidaemia; primary care; Malaysia; low-density lipoprotein cholesterol
• Public URL: https://nottingham-repository.worktribe.com/output/34350994
• Publisher URL: https://cegh.net/article/S2213-3984(24)00115-5/fulltext
• Related Public URLs: https://www.sciencedirect.com/science/article/pii/S2213398424001155