Data
The surveillance system for hypercholesterolemia established by Santé publique France makes it possible to study its prevalence and trends over time.
A similar proportion of adults with high LDL cholesterol among men and women
Nearly one in five adults (19.3% [17.0–21.5]) had LDL-C >1.6 g/L, and 6.0% [4.6–7.4] had LDL-C >1.9 g/L. The mean LDL-c was similar in men and women (p=0.38), as was the distribution of LDL-c values across categories (p=0.65).
The proportion of adults with LDL-C >1.9 g/L increased with age up to 45–54 years (10.3%) and then stabilized at around 7–8%.
Men are more likely to be on lipid-lowering medication
Among all adults, 8.8% received at least one prescription for lipid-lowering medication during the year preceding the health examination. This proportion increased with age (nearly zero among the youngest vs. 28.0% among those aged 65–74) and was significantly higher among men (10.9%) than among women (6.7%).
Adults receiving lipid-lowering therapy were on average 62.0 years old (vs. 45.5 years for those not receiving treatment) and were more often men (60.8% vs. 47.5%).
The prevalence of hypercholesterolemia has remained unchanged since 2006, but screening rates have declined
Between 2006 and 2015, the average LDL cholesterol level and the proportion of adults with LDL-C >1.6 g/L and >1.9 g/L did not change significantly (p-values = 0.09, 0.63, and 0.16, respectively).
Compared to 2006, the proportion of adults who reported having had their cholesterol tested decreased significantly by 8.7% among men (p=0.002) and by 15.5% among women (p<0.0001). This decline affected all age groups except those aged 18–34, for whom this proportion remained stable (p = 0.06).
A proportion of adults on lipid-lowering medication that has decreased since 2006
The proportion of adults receiving lipid-lowering therapy among the general population decreased significantly by 29.6% (p=0.0001). The average LDL cholesterol level remained stable among adults receiving treatment (1.21 g/L) and among those not receiving treatment (1.31 g/L). The type of treatment (statins, fibrates, others) did not change significantly over the period considered (p=0.14).
Regional disparities in the proportion of patients treated with lipid-lowering drugs
The proportion of patients treated with lipid-lowering drugs was not uniform across France in 2014. The highest rates were observed in the Hauts-de-France (14.4%), Grand Est (12.6%), Normandy (12.9%), and Centre-Val de Loire (12.2%) regions. These high rates could be explained by obesity rates above the national average and difficult socioeconomic conditions, particularly in the Hauts-de-France, Grand Est, and Normandy regions.
In contrast, all overseas departments as well as the Auvergne-Rhône-Alpes region had prevalence rates more than 10% below the national rate.
article
6 September 2019
LDL cholesterol among adults in mainland France: average levels, awareness, and treatment in 2015, and trends since 2006