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Epidemiology of dyslipidemia in Tunisia, HSHS 3 study (Hammam Sousse Sahloul Heart Study)

INTRODUCTION

Dyslipidemia is a major cause of morbidity and mortality worldwide because it increases the risk of cardiovascular diseases.

AIM

To determine the prevalence of dyslipidemia and its components in the general population of Hammam Sousse (Tunisia) and to identify its risk factors.

METHODS

This was an analysis of the HSHS database (Hammam Sousse Sahloul Heart Study), a «community-based» cross-sectional study on cardiovascular risk factors including dyslipidemia, with a random sample in two-stages, proportional-probability clusters. All subjects above 20 years underwent a lifestyle interview, clinical examination with anthropometric measurements, and blood sampling. Dyslipidemia was defined by: total cholesterol ≥5.2 mmol/l, hyper LDL (Low Density Lipoprotein) cholesterolemia ≥4.1 mmol/l, hypo HDL (High Density Lipoprotein) cholesterolemia <1.03 mmol/l for men and <1.29 mmol/l for women and hyper-triglyceridaemia: ≥2.26 mmol/l. Multivariate logistic regression analysis was conducted to determine factors independently associated with dyslipidemia.

RESULTS

The study population was composed of 481 males (M) and 960 females (F), with a sex ratio of 0.5. Mean cholesterol was higher in women (5 mmol/l±1.01) than in men (4.8 mmol/l±0.92). Only 24.9% of men and 29.1% of women had normal HDL cholesterol levels. Women had higher levels of hypercholesterolemia and LDL cholesterolemia than men (p<10-6). Multivariate analysis showed that dyslipidemia was independently and statistically significantly associated with age ≥40 years (p<10-3), physical inactivity (p<10-3) and obesity (p=0.025).

CONCLUSION

As a result of the epidemiological situation of dyslipidemia, the promotion of an active lifestyle seems essential. In addition, nutritional education improves the lipid profile by promoting weight loss and balancing lipid consumption.