CARDIOVASCULAR JOURNAL OF AFRICA • Volume 33, No 2, March/April 2022 AFRICA 55 95% CI 1.48–2.41) and residing in rural areas (AOR 1.55; 95% CI 1.29–1.85). Also, being a resident of rural areas and being obese increased the odds of l-HDL (AOR 1.34; 95% CI 1.14– 1.58) and h-CHL (AOR 1.51; 95% CI 1.03–2.15), respectively. Discussion This study shows for the first time, the nationwide prevalence of low HDL-C, elevated LDL-C, hypertriglyceridaemia and hypercholesterolaemia, which were 72.5, 13.6, 21.4 and 7.51%, respectively, with a higher burden observed in women compared tomen and rural compared to urban dwellers. All but lowHDL-C steadily increased with age, peaking in subjects aged 41–50 years or 51–60 years. The adjusted risks of all lipid abnormalities except lowHDL-Cwere higher in hypertensive and obese subjects in comparison to their normotensive and lean counterparts. In addition, residing in rural areas associated positively with increased risk of all but hypercholesterolaemia, while being diabetic doubled the risk of only hypertriglyceridaemia. Until this study, the burden of dyslipidaemia has never been characterised in any nationally representative population of adult Nigerians. A previous attempt by the Federal Ministry of Health was part of a NCD survey22 involving 16 019 subjects from the then three geographical regions of Nigeria, which dates back more than 20 years. The NCD survey of plasma lipids was inadequate for two major reasons; the investigators neither estimated the prevalence of dyslipidaemia nor assessed all lipid fractions. Nevertheless, comparing the mean TC (3.17 ± 1.1 mmol/l) and HDL-C (1.04 ± 0.5 mmol/l) with those of our study shows that the status of average blood levels of TC and HDL-C may have deteriorated by 3.2 and 32.7%, respectively. In line with this and recent evidence from Nigeria10,23 and other black African populations,24,25 it is apparent that the burden of dyslipidaemia in Nigeria, particularly low HDL-C, has increased over time. According to various small pockets of communitybased surveys,10,26-28 the prevalence of low HDL-C, high LDL-C, high TG and high TC in adult Nigerians ranges from 13.0–96.5, 0.8–45.9, 1.8–24.5 to 3.1–35.9%, respectively. In a meta-analysis report involving 294 063 native Africans drawn from 177 studies,7 the pooled prevalence of low HDL-C, high LDL-C, hypertriglyceridaemia and hypercholesterolaemia was 37.4, 28.6, 17.0 and 25.5%, respectively. It is worth noting 100 80 60 40 20 0 < 20 yrs 21–30 yrs 31–40 yrs 41–50 yrs 51–60 yrs 61–70 yrs > 70 yrs Age group Prevalence (%) Low HDL-C High LDL-C High TG High TC Fig. 2. Clustered bar chart showing the prevalence of dyslipidaemia in different age groups. Table 3. Association between lipid abnormalities and diabetes mellitus, obesity, hypertension and place of residence Low HDL-C Elevated LDL-C Elevated TG Elevated TC Variables OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Hypertension Normotensives 1 1 1 1 Hypertensives 0.78 (0.65–0.93) 1.42 (1.13–1.80) 1.21 (1.01–1.47) 2.16 (1.59–2.95) Diabetes mellitus Non-diabetics 1 1 1 1 Diabetics 1.09 (0.72–1.17) 1.26 (0.75–2.03) 2.04 (1.36–3.03) 1.22 (0.62–2.19) BMI category Non-obese 1 1 1 1 Obese 1.06 (0.83–1.38) 1.47 (1.10–1.95) 1.89 (1.48–2.41) 1.51 (1.03–2.15) Place of residence Urban 1 1 1 1 Rural 1.34 (1.14–1.58) 1.38 (1.10–1.73) 1.55 (1.29–1.85) 1.22 (0.84–1.51) OR, odds ratio adjusted for age, gender, cigarette smoking and drinking alcohol. HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; TG, triglycerides; TC, total cholesterol, BMI, body mass index.
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