HDL-knowledge in the lay public: Results of a representative population survey

Abstract

Study objectives

The aim of this study was to examine the extent of the general public's knowledge concerning HDL-cholesterol and to identify the role of gender, age, population size of the locality and socio-economic factors.

Design

Cross-sectional population-based telephone survey.

Setting

Austrian general population.

Participants

Nine hundred and ninety nine subjects aged 16 years or over, randomly selected from the official telephone directory in Austria.

Main results

13.9% of the 999 participants were familiar with the term HDL-cholesterol, correctly identified HDL-cholesterol as the favourable cholesterol component and indicated that HDL-cholesterol should be high rather than low. Knowledge of HDL-cholesterol increased with population size of the locality, total net income of the household and educational level. Respondents in bigger localities had their HDL-cholesterol measured more frequently. Older people and males reported making significantly more attempts to positively influence their HDL-cholesterol level. 29.6% of those respondents familiar with the term HDL-cholesterol reported having had their HDL-cholesterol measured at some point. Physicians, newspapers and television were identified as the most important sources of information on HDL-cholesterol by 79.7, 19.9 and 10.3% of the study subjects, respectively.

Conclusions

Although measuring HDL-cholesterol plays a major role in the assessment of cardiovascular risk, public knowledge about HDL-cholesterol is scarce.

Introduction

The pre-requisite of successful management of cardiovascular risk factors (CVRF) is compliance with prescribed therapeutic regimen. This in turn requires that the individual, labeled as ‘high risk’ fully understands the nature of CVRFs. One of the most important and modifiable CVRFs is hypercholesterolemia. The level of total cholesterol has limited predictive value as CVRF since it is a composite of low density lipoprotein (LDL) and high density lipoprotein (HDL). Both components can be influenced by appropriate lifestyle changes. Prospective studies of large populations have confirmed the role of low HDL-cholesterol as an independent CVRF [1], [2]. Increasing the HDL by one unit has up to three times more beneficial effect on prevention of coronary events than reducing LDL [3], [4], [5]. Lifestyle optimisation is an established approach proven to increase HDL levels [6]. Thus, increased public awareness of the HDL's significance can be of use in promoting desirable life style changes.

Measuring the HDL-cholesterol level is one of the recommended components when screening for CVRF [6], [7], [8] and so HDL-cholesterol is one of the parameters measured at the yearly health check offered in Austria by the Austrian National Health Service free of charge to every adult citizen. If this health check is to have a desirable impact on health the respondents should understand what the measured parameters are and why are they measured. General awareness of CVRFs among women was found to be associated with preventive action, suggesting, that recent efforts to educate women about heart disease and the associated risk factors have been highly successful [9].

Knowledge is empowerment, allowing the individuals to take charge of their own health, and is an important factor in the prevention of disease—a principle aim of public health.

There is virtually no information relating to what extent the lay public and patients understand the nature and significance of HDL.

The primary objective of our study was to ascertain the situation with respect to HDL in the general Austrian community. Our secondary objective was to identify the role of gender, age, population size of locality and socio-economic factors in connection with HDL awareness.