Prevalence of hypercholesterolemia in Nigeria: a systematic review and meta-analysis

Objectives: Elevated blood cholesterol (hypercholesterolemia) is a significant cause of cardiovascular disease. We aimed to estimate national and zonal prevalence of hypercholesterolemia in Nigeria to help guide targeted public health programs. Study design: This is a systematic review and synthesis of publicly available epidemiologic data on hypercholesterolemia in Nigeria. Methods: We systematically searched MEDLINE, EMBASE, Global Health, and Africa Journals Online for studies on the prevalence of hypercholesterolemia in Nigeria published between 1990 and 2018. We used a random-effects meta-analysis (Freeman-Tukey double arcsine transformation) and meta-regression model to estimate the prevalence of hypercholesterolemia in Nigeria in 1995 and 2015. Results: In total, 13 studies (n = 16,981) were retrieved. The pooled crude prevalence of hypercholesterolemia in Nigeria was 38% (95% confidence interval: 26–51), with prevalence in women slightly higher (42%, 23–63) compared with men (38%, 20–58). The prevalence was highest in the South-south (53%, 38–68) and lowest in the South-west (3%, 2–4) and North-east (4%, 2–7). Urban dwellers had a significantly higher rate (52%, 24–79) compared with rural dwellers (10%, 6–15). We estimated over 8.2 million persons (age-adjusted prevalence 16.5%) aged 20 years or more had hypercholesterolemia in Nigeria in 1995, increasing to 21.9 million persons (age-adjusted prevalence 25.9%) in 2015. Conclusions: Our findings suggest a high prevalence of hypercholesterolemia in Nigeria. Urbanization, lifestyles, diets, and culture appear to be driving an increasing prevalence, especially among women. Population-wide awareness and education on reducing elevated cholesterol levels and associated risks should be prioritized.