Prevalence, awareness, treatment, and control of high low-density lipoprotein cholesterol in Brazil: Baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

J Clin Lipidol. 2016 May-Jun;10(3):568-76. doi: 10.1016/j.jacl.2015.12.029. Epub 2016 Jan 14.


Background and objectives: Dyslipidemia is a pivotal risk factor for coronary heart disease (CHD). The purpose of this study was to identify the profile of dyslipidemia in a Brazilian population, according to high low-density lipoprotein (LDL-C) levels. We used the classification of the 2004 update of National Cholesterol Education Program Adult Treatment Panel III (ATP-III).

Methods: Of the 15,105 men and women aged 35 to 74 years enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), we included 14,648 subjects (97%). They had data to categorize them according to the NCEP-ATP-III criteria. We compared 4 categories: "0-1" risk factors, "2 or more risk factors", "CHD or CHD risk equivalent", and "CHD at very high risk". The sociodemographic determinants used were sex, age, ethnicity, income, education, and health insurance. Poisson regression was used to estimate the prevalence ratios for cholesterol (LDL-C), frequency, awareness, treatment, and control of high LDL-C.

Results: The frequencies of high LDL-C, awareness, treatment, and control were 45.5%, 58.1%, 42.3%, and 58.3%, respectively. After adjustment for sociodemographic determinants, the prevalence ratios for high LDL-C were significantly higher for men, blacks, older subjects, and subjects with lower levels of education. Low frequency of awareness, treatment, and uncontrolled values of LDL-C was observed among men, mixed race and blacks, poorer, less educated, and those who did not have private health insurance.

Conclusions: The prevalence of high LDL-C was elevated in this Brazilian population, with low rates of awareness, treatment and control, and remarkable socioeconomic disparity.

Keywords: Cardiovascular; Coronary heart disease; Dyslipidemia; Epidemiology; Risk factors; Statins.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Brazil / epidemiology
  • Cholesterol, LDL / blood*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / epidemiology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prevalence


  • Cholesterol, LDL