Long-term trends in dyslipidemia prevalence, awareness, treatment, and control in the Middle East and North Africa: a meta-analysis of 116 representative surveys.

BACKGROUND AND AIMS: Dyslipidemia is a major risk factor for cardiovascular disease. Trends in dyslipidemia prevalence have been poorly described in the Middle East and North Africa region (MENA). We evaluated the prevalence of dyslipidemia, temporal trends, and reports on awareness, treatment, and control.

METHODS

MEDLINE, Scopus, and Web of Science were searched for population-representative studies -supplemented by WHO STEPS reports. Prevalence of dyslipidemia (hypercholesterolemia, hypertriglyceridemia, low HDL, and elevated LDL) was pooled via random-effects meta-analysis. Average Annual Percentage Changes (AAPC) in the prevalence of dyslipidemia were calculated using joinpoint regression. Temporal trends were visualized via Locally Estimated Scatterplot Smoothing.

RESULTS

116 studies (628,134 individuals) were included in meta-analysis. Nominal pooled proportions were 0.69 (95% CI: 0.63-0.74; 95%PI: 0.38-0.92) for dyslipidemia, 0.33 (95%CI: 0.30-0.36) for hypertriglyceridemia, 0.35 (95%CI 0.31- 0.38) for hypercholesterolemia, 0.29 (95%CI: 0.24-0.35) for high LDL, and 0.50 (95%CI: 0.45-0.55) for Low HDL - all subject to substantial heterogeneity. A temporal decrease in hypercholesterolemia (AAPC 1982-2023: -1.52, 95%CI: -2.80--0.23) was noted without significant changes in other components. A higher proportion of women (0.72, 95%CI: 0.66-0.77 vs. 0.65, 95%CI: 0.59-0.70) had dyslipidemia. Awareness (9.2-28.5%) and treatment (3.0-28.6%) varied widely across studies.

CONCLUSIONS

Although dyslipidemia remains prevalent in MENA, awareness and treatment in most areas are low. Estimates vary substantially across different areas. Effective prevention, detection, and management strategies adopted to local needs are needed. Further research into determinants, and associations with other modifiable risk factors are also required.

PROTOCOL REGISTRATION: PROSPERO, ID: CRD420251114986.