Original Article Equivalence of Cholesterol Levels at Hospital-based Health-Check Program with Population-based Studies: A Comparative Study

Background: High cholesterol is an important coronary risk factor. Only limited population-based studies have reported prevalence of hypercholesterolemia in India. Hospital-based data on cholesterol levels are available but have not been used to determine population-wide prevalence. Objective:To determine equivalence of hospital-based cholesterol levels with population-based levels for identification of hypercholesterolemia. Methods: Successive individuals undergoing measurements of total cholesterol levels at a tertiary-care hospital-based preventive health checkup program (primary and secondary prevention) were recruited. We compared total cholesterol levels in this group with two population-based studies – Jaipur Heart Watch (JHW) conducted in Jaipur and India Heart Watch (IHW) in 11 cities in India. Age-specific and age-adjusted levels and prevalence of hypercholesterolemia in the three groups were compared. Descriptive statistics are reported. Results: We evaluated 45,534 subjects from hospital-based health checkup program, 1941 in JHW and 6123 in IHW. Age-adjusted mean levels of cholesterol in the three studies, respectively, were in men 170.6±46, 188.5±38 and 178.4±39 mg/dL (p<0.001), and in women 186.4±43, 182.2±36 and 184.6±39 mg/dL (p=n.s.). In hospital-based studies the levels were significantly lower among men in age groups>40 years and women>50 years, while no difference was observed in younger age-groups. Age-adjusted prevalence (%) of hypercholesterolemia>200 mg/dL in the three groups, respectively, were in men 28.1, 28.9 and 25.1 and in women 27.8, 25.6 and 24.9 (p<0.05). Hypercholesterolemia>240 mg/dL was in men 7.5, 6.8 and 6.2 and in women 7.8, 6.1 and 5.4 (p<0.01). Conclusions: Cholesterol levels and hypercholesterolemia prevalence in hospital-based subjects are significantly different from population-based studies, especially in older subjects. (J Clin Prev Cardiol 2013;2(1):1-7