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. 2023 Jan-Feb:69:1-8.
doi: 10.1016/j.hjc.2022.10.002. Epub 2022 Oct 13.

Twenty-first century epidemiology of dyslipidemia in Greece: EMENO national epidemiological study

George S Stergiou  1 , Angeliki Ntineri  2 , Ariadni Menti  2 , Natasa Kalpourtzi  3 , Charalambos Vlachopoulos  4 , Evangelos N Liberopoulos  5 , Loukianos Rallidis  6 , Dimitris Richter  7 , Magda Gavana  8 , Apostolos Vantarakis  9 , Grigoris Chlouverakis  10 , Christos Hajichristodoulou  11 , Grigoris Trypsianis  12 , Paraskevi V Voulgari  13 , Yannis Alamanos  14 , Argiro Karakosta  3 , Giota Touloumi  3
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Free article

Twenty-first century epidemiology of dyslipidemia in Greece: EMENO national epidemiological study

George S Stergiou et al. Hellenic J Cardiol. 2023 Jan-Feb.
Free article

Abstract

Background: Greece was recently reclassified from low- to medium-risk country in terms of cardiovascular disease, with 27% of cardiovascular deaths attributed to hypercholesterolemia. EMENO nationwide survey (2013-2016) assessed the epidemiology of dyslipidemia in the general population in Greece.

Methods: A random sample of adults was drawn by multistage stratified random sampling based on 2011 census. Standardized questionnaires and blood tests for total cholesterol (TC), low-density (LDL-C), and high-density lipoprotein cholesterol (HDL-C), and triglycerides were used. Hypercholesterolemia was defined as TC ≥ 240/200 mg/dL and/or the use of lipid-lowering drugs, hyper-LDL-cholesterolemia as LDL-C ≥160/130/100 mg/dL and/or the use of drugs, hypo-HDL-cholesterolemia as HDL-C <40 mg/dL, and hypertriglyceridemia as triglycerides ≥150 mg/dL. Weighted analysis was applied to adjust for study design, age/sex distribution discrepancies between sample and population and nonresponse.

Results: Of 6,006 individuals recruited, 4,298 were analyzed (mean [SD] age 49.2 [18.5] years, men 48.5%, BMI 28.2 [5.7] kg/m2). Mean TC, LDL-C, HDL-C, and TG were 193.9 [44.4], 118.5 [37.6], 49.1 [14.9], and 130.8 [94.4] mg/dL, respectively. The prevalence of hypercholesterolemia was 27.6/52.4% for thresholds ≥240/200 mg/dL, and of hyper-LDL-cholesterolemia was 26.3/46.7/74% for thresholds ≥160/130/100 mg/dL, with no differences between sexes. The prevalence of hypo-HDL-cholesterolemia was 27.5% (men/women 38.1/17.5%, p < 0.001) and of hypertriglyceridemia was 27.8% (men/women 32.6/23.4%, p < 0.001). Lipid-lowering drugs were used by 14.1% of the participants (men/women 12.6/15.6%, p < 0.001).

Conclusions: More than 50% of adults in Greece have some type of dyslipidemia (mainly TC ≥ 200 mg/dL) and 14% are treated. Nationwide programmes are needed to manage dyslipidemia and halt the increasing rate of cardiovascular disease in Greece.

Keywords: Dyslipidemia; Epidemiology; Lipid-lowering treatment; National; Survey.

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Conflict of interest statement

Declaration of competing interest GSS reports advisory and lecture fees from Astra-Zeneca, Menarini, Novartis, Sanofi-Aventis, Servier. CV reports research grants and honoraria from Amgen, Vianex, Elpen, Pfizer, Lilly, Menarini, Servier, Sanofi, Viatris, Winmedica. ENL reports personal fees paid to his institution from Amgen, Novartis, Sanofi, Novo Nordisk, Lilly and Servier, outside the submitted work. LR reports research grants and honoraria from Amgen, Elpen, Sanofi-Aventis, Mylan, Novartis, and Servier. DR reports personal fees for lectures and AB from Amgen, Novartis, Sanofi, Novo Nordisk, Lilly and Servier, Menarini, Viatris, Recordati, Boehringer, Elpen, Bayer, Roche, Medtronic, Edwards, Astra-Zeneca, Demo, outside the submitted work. MG received honoraria paid through her institution from Merck, for advisory boards and lectures unrelated to this study. GT has received EU and National resources grants as well as a grant from the Hellenic Diabetes Association, all paid to her institution, to support this study and grants unrelated to this study and paid to her institution from Gilead Sciences Europe, UCL, ECDC, EU, and National funds. The other authors report no relationships that could be construed as a conflict of interest.

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