Public perceptions and knowledge of cholesterol management in a multi-ethnic Asian population: A population-based survey

• Published in: PloS one 2021-08, Vol.16 (8), p.e0256218
• Main Authors: Lim, Chiw Yeh, Ho, Jien Sze, Huang, Zijuan, Gao, Fei, Tan, Swee Yaw, Koh, Woon Puay, Chua, Terrance, Low, Lip Ping, Tan, Huay Cheem, Yoon, Sungwon
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anticholesteremic Agents - therapeutic use; Asian People - ethnology; Biology and Life Sciences; Cardiology; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Cardiovascular Diseases - psychology; Cholesterol; Demographics; Demography; Disease management; Education; Employment; Ethnicity; Evaluation; Female; Health Knowledge, Attitudes, Practice; Health promotion; Health risks; Health services; Heart attacks; Herbal medicine; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia - complications; Hypercholesterolemia - drug therapy; Hypercholesterolemia - epidemiology; Hypercholesterolemia - psychology; Hyperlipidemia; Knowledge; Male; Management; Medicine and Health Sciences; Middle Aged; Minority & ethnic groups; Mortality; Patient education; Polls & surveys; Population; Public awareness; Public health administration; Questionnaires; Risk analysis; Risk factors; Signs and symptoms; Singapore - epidemiology; Social Sciences; Sociodemographics; Statins; Statistical analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0256218

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide. Hyperlipidemia is one of the important modifiable risk factors for CVDs. Raising public awareness of CVD risks is an important step in reducing CVD burdens. In this study, we aimed to assess public awareness and knowledge of cholesterol and its management in a multiethnic Asian population. We recruited 1000 participants from three major ethnic groups for this nationwide population-based survey. A structured questionnaire was used to collect socio-demographics, knowledge of cholesterol and cholesterol-lowering medications. Univariate and multivariate analyses were conducted to identify factors associated with good knowledge on cholesterol and its management. Of the participants, 65% thought that high cholesterol produces symptoms and that lifestyle modification would be as effective as medication at lowering cholesterol. Nearly 70% believed that long term statin could lead to kidney or liver damage, and 56% thought that statin was associated with higher risk of cancer. A third saw herbal medicine or supplements as healthier and safer. About 45% believed that statin therapy should not be taken long term and that one could stop taking cholesterol medication when cholesterol is under control. Malays were more likely to have poor knowledge (adjusted OR 0.68; 95% CI 0.47-0.98; P = 0.039) compared to Chinese. Participants with intermediate education were more likely to have good knowledge of cholesterol and its management (adjusted OR 1.67; 95% CI 1.11-2.51; P = 0.013) compared to those with primary education. Public knowledge and awareness of high cholesterol and its management remains poor in Asian multi-ethnic population. Understanding gaps in public knowledge can inform the implementation of health promotion programs to effectively raise awareness of cholesterol and its management.