Despite the contribution of dyslipidemia to the high and rising burden of arteriosclerotic cardiovascular disease (CVD) in Sub-Saharan Africa; the condition is under-diagnosed, under-treated, and under-described. The objective of this study was to explore the prevalence of dyslipidemias, estimate a 10-year cardiovascular disease risk and associated factors in adults (≥ 35 to ≤ 85 years) living in Asmara, Eritrea. This population-based cross-sectional study was conducted among individuals without overt CVDs in Asmara, Eritrea, from October 2020 to November 2020. After stratified multistage sampling, a total of 386 (144 (37%) males and 242 (63%) females, mean age ± SD, 52.17 ± 13.29 years) respondents were randomly selected. The WHO NCD STEPS instrument version 3.1 questionnaire was used to collect data. Information on socio-demographic variables was collected via interviews by trained data collectors. Measurements/or analyses including anthropometric, lipid panel, fasting plasma glucose, and blood pressure were also undertaken. Finally, data was analyzed by using Statistical Package for Social Sciences version 26.0 for Windows (SPSS Inc., Chicago, IL, USA). All p-values were 2-sided and the level of significance was set at p < 0.05 for all analyses. The frequency of dyslipidemia in this population was disproportionately high (87.4%) with the worst affected subgroup in the 51–60 age band. Further, 98% of the study participants were not aware of their diagnosis. In terms of individual lipid markers, the proportions were as follows: low HDL-C (55.2%); high TC (49.7%); high LDL (44.8%); high TG (38.1%). The mean ± SD, for HDL-C, TC, LDL-C, non-HDL-C, and TG were 45.28 ± 9.60; 205.24 ± 45.77; 130.77 ± 36.15; 160.22 ± 42.09 and 144.5 ± 61.26 mg/dL, respectively. Regarding NCEP ATP III risk criteria, 17.6%, 19.4%, 16.3%, 19.7%, and 54.7% were in high or very high-risk categories for TC, Non-HDL-C, TG, LDL-C, and HDL-C, respectively. Among all respondents, 59.6% had mixed dyslipidemias with TC + TG + LDL-C dominating. In addition, 27.3%, 28.04%, 23.0%, and 8.6% had abnormalities in 1, 2, 3 and 4 lipid abnormalities, respectively. Multivariate logistic regression modeling suggested that dyslipidemia was lower in subjects who were employed (aOR 0.48, 95% CI 0.24–0.97, p = 0.015); self-employed (aOR 0.41, 95% CI 0.17–1.00, p = 0.018); and married (aOR 2.35, 95% CI 1.19–4.66, p = 0.009). A higher likelihood of dyslipidemia was also associated with increasing DBP (aOR 1.04 mmHg (1.00–1.09, p = 0.001) and increasing FPG (aOR 1.02 per 1 mg/dL, 95% CI 1.00–1.05, p = 0.001). Separately, Framingham CVD Risk score estimates suggested that 12.7% and 2.8% were at 10 years CVD high risk or very high-risk strata. High frequency of poor lipid health may be a prominent contributor to the high burden of atherosclerotic CVDs—related mortality and morbidity in Asmara, Eritrea. Consequently, efforts directed at early detection, and evidence-based interventions are warranted. The low awareness rate also points at education within the population as a possible intervention pathway.

Background: The objective of this study was to estimate the prevalence of dyslipidemias and associated factors in adults (≥35 to ≤ 85 years) living in Asmara, Eritrea. Methods: A total of 384 (144 (%) males and 242 (%) females, mean age ± SD, 68.06±6.16 years) respondents were randomly selected after stratified multistage sampling. The WHO NCD STEPS instrument version 3.1 questionnaire was used to collect data. Measurements/or analysis including anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) were also undertaken. Results: The frequency of dyslipidemia in this population was disproportionately high (87.4%) with the worst affected subgroup in the 51-60 age band. The level of awareness was also low. In terms of individual lipid markers, the proportion were as follows: HDL-C (40 mg/dL men and 50 mg/dL females) (55.2%); TC ≥ 200 mg/d (49.7%); LDL≥130 mg/dL (44.8%); TG≥150 mg/dL (38.1%). The mean ± SD, for HDL-C, TC, LDL-C, non-HDL-C, and TG were 45.28±9.60; 205.24±45.77; 130.77±36.15; 160.22±42.09 and 144.5±61.26 mg/dl, respectively. Regarding NCEP ATP III risk criteria, 17.6%, 19.4%, 16.3%, 19.7%, and 54.7% were in high or very high-risk categories for TC, Non-HDL-C, TG, LDL-C, and HDL-C, respectively. Among all respondents, 59.6% had mixed dyslipidemias with TC+TG+LDL-C dominating. In addition, 27.3%, 28.04%, 23.0%, and 8.6% had abnormalities in 1, 2, 3 and 4 lipid abnormalities, respectively. In terms of Framingham CVD Risk scores, 12.7%, 2.8% were in the high risk and very high-risk strata. Further, the high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (71.8%), BMI≥25 kg/m2 (44.6%), dysglycemia (24.7%), hypertension (24.4%), and physical inactivity. Dyslipidemia was associated with employment status (ref: unemployed vs. employed, aOR 0.48, 95% CI 0.24–0.97, p=0.015) and self-employed (aOR 0.41, 95% CI 0.17–1.00, p=0.018); marital status (ref: not married vs married (aOR 2.35, 95% CI 1.19–4.66, p=0.009); increasing DBP (aOR 1.04 mmHg (1.00-1.09)=0.001) and increasing FPG (aOR 1.02 per 1 mg/dL, 95% CI 1.00–1.05, p=0.001). Conclusion: High frequency of poor lipid health may be a prominent contributor to the high burden of CVDs – related mortality and morbidity in Asmara, Eritrea. Consequently, efforts directed at early detection, and evidence-based interventions are warranted.