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Samaha et al. Hyperlipidemia in Lebanon

cholesterol (LDL-C) and CAD or atherosclerosis. [4-6] METHODS
Thus, it is not surprising that the major consequence of
hypercholesterolemia is atherosclerosis. [7,8] The major Study population
hallmark of atherosclerosis is the buildup of lipids, This cross-sectional study recruited 2,000 participants;
mainly cholesterol, in the vascular wall. 997 of whom were later excluded because of the
existence of illness with the potential to modulate
Atherosclerosis is the most common CVD, and lipid profiles, such as diabetes mellitus or the use of
conditions associated with it, such as stroke and acute lipid altering medications. Diabetes was defined as
myocardial infarction (AMI), continue to be the leading having a fasting glucose level of ≥ 126 mg/dL or by
causes of morbidity throughout the world. [9,10] By the use of glucose-lowering drugs. Demographically,
causing a reduction in the vessel lumen, atherosclerotic the remaining 1,003 individuals included in the study
plaques may dramatically diminish blood supply to were distributed over the different geographic regions
tissues, which could have deleterious effects on the of Lebanon. Of these subjects, 501 were females and
nourishment and oxygen supply of these tissues. [11] 502 males, all reported to be healthy with unremarkable
previous medical history. Surprisingly, more than 70%
Hypercholesterolemia remains a leading risk factor in of the subjects were unaware of their lipids profiles.
both developed and developing countries. Several Subjects were grouped in 20-year intervals. All
[12]
studies have reported that a decrease in the serum participants above 55-year-old were assigned to one-
age interval.
levels of total cholesterol (TC) and LDL-C leads to a
reduction in the risk of coronary events and is thus Data collection and definitions
an effective strategy in secondary prevention. [13-17] It Questionnaires were distributed with instructions
is also well documented that hyperlipidemia plays a for self-administration and collected one week later.
major role in the development of many CVDs including Incomplete questionnaires were completed during
atherosclerosis. [2,4,5] short personal interviews. Information concerning
height, weight, alcohol intake, smoking, and physical
There are many risk factors for atherosclerosis, such activity were recorded. Measurements of height and
as gender, diabetes, stress, and hypertension. weight were taken with the participants wearing no
[18]
However, hypercholesterolemia in particular is critical shoes and very light clothing. Height was measured
for the genesis of the disease as it plays a permissive to the nearest 0.5 cm using a standard physician’s
role in the development of other pathogenic factors height stadiometer. Body weight was measured to the
such as insulin resistance and vascular inflammation. nearest 0.1 kg using a portable balance scale. Body
[19]
Notably, the relationship between atherosclerosis and mass index (BMI; kg/m ) was calculated as weight (kg)
2
hypercholesterolemia is affected by lifestyle factors, divided by the square of the height (m).
including physical activity and smoking.
Hypercholesterolemia was defined as having blood
Lebanon is considered a third-world country. total cholesterol of ≥ 200 mg/dL.
Alarmingly, no large studies have been conducted
to determine the prevalence of hyperlipidemia in the Participants not undergoing regular physical exercise
Lebanese population. There are no national studies for at least 30 min twice a week were considered
showing the impact of lifestyle-related factors, such as sedentary.
diet, physical activity, alcohol consumption, or smoking
on blood levels of lipids. Despite the findings that the Smoking was defined as smoking an average of one or
Mediterranean diet may help reduce CVD risk and more cigarettes per day.
mortality, nothing is known about this relation in Nutritional data were collected and pertained to the
[20]
Lebanon, a small Mediterranean country. Interestingly, frequency of consumption of fatty meat, entire dairy
there has been a change in the dietary habits, products, skimmed milk, eggs, as well as fruits and
particularly in the 20-30 years old age group living in vegetables.
large cities in Lebanon.
Informed consent was obtained for all participants,
This study was therefore undertaken to first determine either directly (for those 18 years or older) or through
the prevalence and awareness of hyperlipidemia the parents/legal guardians (for subjects under 18
in Lebanon. It was also designed to examine the years of age).
influence of diet and lifestyle factors on lipidemia in the
Lebanese population. The protocols followed for data collection, handling,
Vessel Plus ¦ Volume 1 ¦ September 26, 2017 99