Rural-urban differences in prevalence of diagnosed dyslipidemia in Newfoundland: findings from the Eastern Health laboratory information system

Abstract

Background Newfoundland and Labrador has a higher level of cardiovascular disease (CVD) mortality than any other Canadian province. This may be partially explained by the lipid profile of this province. Anecdotal evidence suggests that Newfoundlanders have lower levels of high-density lipoproteins (HDL) and higher levels of lowdensity lipoproteins (LDL) than other Canadians. It is unclear if lipid profiles differ between rural and urban locations within Newfoundland. This study aims to assess rural-urban differences in prevalence of diagnosed dyslipidemia in NL Methods This is a cross-sectional study design using a secondary data analysis of laboratory data from the Eastern Health Authority. It includes 94,612 patients aged 20+ with a complete lipid profile (HDL, LDL, Triglyceride (TG), Total Cholesterol) from the period of January 1, 2009 to December 31, 2010. Primary outcome measures were low HDL (<1.0 for men and <1.3 for women), high LDL (≥3.4), high TG (≥1.7), high Total Cholesterol (≥5.2). Rural and urban area were identified using three digit postal code and geo-referenced for visualization using ArcMap-GIS 10.2. Results Rural residents had a significantly higher prevalence of low HDL (48% vs 44%, p <0.001), high TG (35% vs 29%, p <0.001), and high Total Cholesterol/HDL ratio (26% vs 23%, p <0.001). Urban inhabitants had a significantly higher prevalence of high Total Cholesterol (38% vs 37%, p= 0.035). Conclusions The analysis suggests that patterns of dyslipidemia differ between rural and urban regions with rural having a more adverse dyslipidemia lipid profile. The results of this study will help guide future research about dyslipidemia as well as other risk factors for CVD in NL. Further investigation is required using data from all health authorities in NL to better represent the differences.