Yonsei Med J.  2017 Mar;58(2):326-338. 10.3349/ymj.2017.58.2.326.

Management Status of Cardiovascular Disease Risk Factors for Dyslipidemia among Korean Adults

• Lee J
• Son H
• Ryu OH

• KMID: 2427121
• DOI: http://doi.org/10.3349/ymj.2017.58.2.326

Abstract

PURPOSE
Dyslipidemia, hypertension, and diabetes are well-established risk factors for cardiovascular disease (CVD). This study investigated the prevalence and management status of these factors for dyslipidemia among Korean adults aged 30 years old and older.
MATERIALS AND METHODS
The prevalence and management status of dyslipidemia, hypertension, and diabetes were analyzed among 12229 subjects (≥30 years) participating in the Korea National Health and Nutrition Survey 2010-2012. Dyslipidemia was defined according to treatment criteria rather than diagnostic criteria in Korea. Therefore, hyper-low-density lipoprotein (LDL) cholesterolemia was defined if LDL cholesterol levels exceeded the appropriate risk-based threshold established by the National Cholesterol Education Program Adult Treatment Panel III.
RESULTS
The age-standardized prevalence was highest for dyslipidemia (39.6%), followed by hypertension (32.8%) and diabetes (9.8%). The lowest patient awareness was found for dyslipidemia (27.9%). The treatment rate was 66.5% for diabetes and 57.3% for hypertension, but only 15.7% for dyslipidemia. The control rate among those undergoing treatment was highest for hypertension (64.2%), followed by dyslipidemia (59.2%) and diabetes (22.1%). The higher the risk levels of CVD were, the lower the control rate of dyslipidemia.
CONCLUSION
While the prevalence of dyslipidemia was higher than hypertension and diabetes, awareness and treatment rates thereof were lower. Higher CVD-risk categories showed lower control rates of dyslipidemia. In order to improve awareness and control rates of dyslipidemia, diagnostic criteria should be reconciled with treatment targets based on cardiovascular risk in Korean populations.

Keyword

Management; dyslipidemia; diabetes mellitus; hypertension

MeSH Terms

Adult
Aged
Aged, 80 and over
Awareness
Cardiovascular Diseases/ethnology/therapy
Cholesterol, HDL/blood
Cholesterol, LDL/blood
Diabetes Mellitus/*ethnology/therapy
*Disease Management
Dyslipidemias/*ethnology/therapy
Female
*Health Knowledge, Attitudes, Practice
Humans
Hypertension/complications/*ethnology/therapy
Lipoproteins, LDL
Male
Middle Aged
Nutrition Surveys
Prevalence
Republic of Korea/epidemiology
Risk Factors
Cholesterol, HDL
Cholesterol, LDL
Lipoproteins, LDL

Figure

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  Fig. 1 Prevalence and management of dyslipidemia by age groups. p values for difference in rates between men and women were calculated by Fisher's exact two-tailed test.

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  Fig. 2 Prevalence and management of hypertension by age groups. p values for difference in rates between men and women were calculated by Fisher's exact two-tailed test.

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  Fig. 3 Prevalence and management of diabetes by age groups. p values for difference in rates between men and women were calculated by Fisher's exact two-tailed test.

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  Fig. 4 Age-standardized prevalence and management of hyper-LDL-cholesterolemia. p values for difference in rates between men and women were calculated by Fisher's exact two-tailed test. LDL, low-density lipoprotein.

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  Fig. 5 Risk factor status and prevalence of hyper-LDL-cholesterolemia. 1) Obesity: body mass index ≥25 kg/m2. AO: waist circumference ≥90 cm in men, or 85 cm in women. Hyper-TG: TG ≥150 mg/dL. Hypo-HDL-C: HDL-C <40 mg/dL in men, or <50 mg/dL in women. 2) p values for difference in prevalence rates were calculated by Fisher's exact two-tailed test. AO, abdominal obesity; TG, triglycerides; HDL-C, high-density lipoprotein cholesterol; MS, metabolic syndrome; LDL, low-density lipoprotein.

Reference

1. Statistics Korea. 2015 Annual report on the cause of death statistics. accessed on 2016 September 27. Available at: http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&bSeq=&aSeq=356345&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt.

2. Cooper R, Cutler J, Desvigne-Nickens P, Fortmann SP, Friedman L, Havlik R, et al. Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention. Circulation. 2000; 102:3137–3147.

3. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014; 129:e28–e292.

4. Okamura T. Dyslipidemia and cardiovascular disease: a series of epidemiologic studies in Japanese populations. J Epidemiol. 2010; 20:259–265.

5. Korean Society of Lipidology and Atherosclerosis. Dyslipidemia Fact Sheet in Korea 2015. accessed on 2016 June 18. Available at: http://www.lipid.or.kr/bbs/?code=fact_sheet.

6. Kim HJ, Kim Y, Cho Y, Jun B, Oh KW. Trends in the prevalence of major cardiovascular disease risk factors among Korean adults: results from the Korea National Health and Nutrition Examination Survey, 1998-2012. Int J Cardiol. 2014; 174:64–72.

7. Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: National Korea National Health and Nutrition Survey (KNHANES V). 2013. accessed on 2015 January 28. Available at: http://knhanes.cdc.go.kr/knhanes/index.do.

8. Roh E, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, et al. Prevalence and Management of Dyslipidemia in Korea: Korea National Health and Nutrition Examination Survey during 1998 to 2010. Diabetes Metab J. 2013; 37:433–449.

9. Ministry of Health and Welfare. 2014 revised criteria for medical care benefits: drug therapy for hyperlipidemia (Notice No. 2013-210). accessed on 2016 June 30. Available at: http://www.mohw.go.kr/front_new/jb/sjb0406vw.jsp?PAR_MENU_ID=03&MENU_ID=030406&CONT_SEQ=321852&page=1.

10. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486–2497.

11. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004; 110:227–239.

12. National Health Insurance Service. 2009 Guideline for the Korea National Screening Program. accessed on 2016 June 30. Available at: http://www.mohw.go.kr/front_new/jb/sjb0403vw.jsp?PAR_MENU_ID=03&MENU_ID=030403&CONT_SEQ=222527&page=1.

13. World Health Organization, Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Australia;2000.

14. Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998; 15:539–553.

15. Committee for Guidelines for Management of Dyslipidemia. 2015 Korean Guidelines for Management of Dyslipidemia. J Lipid Atheroscler. 2015; 4:61–92.

16. Ahn E, Shin DW, Yang HK, Yun JM, Chun SH, Suh B, et al. Treatment gap in the national health-screening program in Korea: claim-based follow-up of statin use for sustained Hypercholesterolemia. J Korean Med Sci. 2015; 30:1266–1272.

17. Cho YG, Song HJ, Park BJ. The comparison of guidelines for management of dyslipidemia and the appropriateness of them in Korea. Korean J Fam Med. 2010; 31:171–181.

18. Lee YH, Lee SG, Lee MH, Kim JH, Lee BW, Kang ES, et al. Serum cholesterol concentration and prevalence, awareness, treatment, and control of high low-density lipoprotein cholesterol in the Korea national health and nutrition examination surveys 2008-2010: beyond the tip of the iceberg. J Am Heart Assoc. 2014; 3:e000650.

19. Pan L, Yang Z, Wu Y, Yin RX, Liao Y, Wang J, et al. The prevalence, awareness, treatment and control of dyslipidemia among adults in China. Atherosclerosis. 2016; 248:2–9.

20. Bu S, Ruan D, Yang Z, Xing X, Zhao W, Wang N, et al. Sex-specific prevalence of diabetes and cardiovascular risk factors in the middle-aged population of China: a subgroup analysis of the 2007-2008 China national diabetes and metabolic disorders study. PLoS One. 2015; 10:e0139039.

21. Arai H, Yamamoto A, Matsuzawa Y, Saito Y, Yamada N, Oikawa S, et al. Prevalence of metabolic syndrome in the general Japanese population in 2000. J Atheroscler Thromb. 2006; 13:202–208.