Magnitude and management of hypercholesterolemia in the adult population of Spain, 2008-2010: The ENRICA Study

Rev Esp Cardiol (Engl Ed). 2012 Jun;65(6):551-8. doi: 10.1016/j.recesp.2012.02.005. Epub 2012 Apr 5.


Introduction and objectives: Only a few studies have reported nationwide population-based data on the magnitude and control of hypercholesterolemia. This work examines the prevalence and management of hypercholesterolemia in Spain.

Methods: Cross-sectional study conducted from June 2008 to October 2010 on 11,554 individuals representative of the population aged ≥ 18 years in Spain. Study participants provided 12-h fasting blood samples, which were analyzed in a central laboratory with standardized methods.

Results: In the whole population, 50.5% had hypercholesterolemia (total cholesterol ≥ 200 mg/dL or drug treatment) and 44.9% high levels of low-density lipoprotein cholesterol (≥ 130 mg/dL or drug treatment), with no substantial sex-related differences. Moreover, 25.5% of men showed high-density lipoprotein cholesterol < 40 mg/dL and 26.4% of women high-density lipoprotein cholesterol <50mg/dL. Also, 23.2% of men and 11.7% of women had triglycerides ≥ 150 mg/dL. Frequency of dyslipidemia increased up to 65 years, except for low high-density lipoprotein cholesterol which did not vary with age. Among those with high low-density lipoprotein cholesterol, 53.6% knew of it and 44.1% of them received lipid-lowering treatment; among the latter, 55.7% had a controlled level (13.2% of all hypercholesterolemics). Control of high low-density lipoprotein cholesterol increased with age and with the number of visits to the specialist physician, but was lower among diabetics (odds ratio=0.38; 95% confidence interval, 0.28-0.53) and patients with cardiovascular disease (odds ratio=0.55; 95% confidence interval, 0.33-0.92).

Conclusions: About half of the Spanish population has elevated serum cholesterol; moreover, cholesterol control is poor, particularly among those with highest cardiovascular risk, such as diabetics or patients with cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cross-Sectional Studies
  • Diabetes Mellitus / blood
  • Fasting / blood
  • Female
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • Sex Factors
  • Spain / epidemiology
  • Triglycerides / blood
  • Young Adult


  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides