Landscape of Dyslipidemia in China

OBJECTIVES: Cardiovascular diseases (CVD) are the leading mortality cause in China due to rapidly aging population and unfavorable lifestyle change caused by urbanization. Elevated level of low-density lipoprotein cholesterol (LDL-C) is one of the key modifiable CVD risk factors. This study reviewed publications on epidemiology, disease burden, and treatment landscape related to dyslipidemia in China and compared findings with other advanced countries.

METHODS: A targeted literature review was conducted using PubMed, Institute for Health Metrics and Evaluation, and Chinese literature databases such as WanFang and China National Knowledge Infrastructure (CNKI). Relevant publications were identified based on the research questions.

RESULTS: Seven studies showed that the prevalence of dyslipidemia among Chinese adults (aged ≥35 years) ranged between 34% and 48%. Latest literatures showed that rates of disease awareness, treatment and control for dyslipidemia are 64.0%, 18.9% and 7.2%, respectively. China’s prevalence of hypercholesterolemia (LDL-C ≥160mg/dL) has been rising from 2.1% (2010) to 7.2% (2015). From 2000 to 2019, China reported 5.36% to 8.76% of all-cause mortality, and 11.2 million to 19.8 million disability-adjusted life years (DALYs) among adults (aged ≥20 years). Compared with China, the USA and the UK reported 4.2 million and 0.78 million DALYs in 2019, respectively. Healthy China 2030 prioritized the prevention and control of CVD and its risk factors, but dyslipidemia management including high LDL-C, is relatively neglected. Despite statin being a common treatment option, it was only available in 49.7% of 3,041 surveyed primary care institutions. New public health strategies, innovative treatments, advanced digital solutions, and family doctor services could be further leveraged to optimize dyslipidemia management.

CONCLUSIONS: This review corroborates an increasing prevalence and disease burden of dyslipidemia especially uncontrolled LDL-C in China, urging for a clear, scientific, and standardized patient journey, which includes screening, diagnosis, treatment, and management of dyslipidemia.