Lipid profile evaluation and severe hypercholesterolaemia screening in the middle-aged population according to nationwide primary prevention programme in Lithuania Sandra Kutkiene a, c, d, * , Zaneta Petrulioniene a, c, d , Aleksandras Laucevicius a, c, d , Rimante Cerkauskiene b, c , Justina Staigyte c , Akvile Saulyte c , Emilija Petrulionyte c , Urte Gargalskaite c, d , Egle Skiauteryte c, d , Gabija Matuzeviciene c, d , Milda Kovaite d , Egidija Rinkuniene a, c, d a Vilnius University, Faculty of Medicine, Clinic of Cardiac and Vascular Diseases, Santariskiu str. 2, LT-08661, Vilnius, Lithuania b Children‘s Hospital, Vilnius University Hospital Santaros Klinikos, Santariskiu str. 7, LT-08406, Vilnius, Lithuania c Vilnius University, Faculty of Medicine, M. K. Ciurlionio str. 21, 03101, Vilnius, Lithuania d Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania article info Article history: Received 31 March 2018 Received in revised form 29 May 2018 Accepted 7 June 2018 Keywords: Severe hypercholesterolaemia LDL cholesterol Total cholesterol Triglycerides Cardiovascular risk Primary prevention Middle-aged population abstract Background and aims: Cardiovascular disease (CVD) is a major cause of premature death in Lithuania where abnormal lipid levels are very common among middle-aged adults. The aim of this study was to evaluate lipid profile in middle-aged Lithuanians and perform population-based severe hyper- cholesterolaemia (SH) screening. Methods: This study included men aged 40e54 and women aged 50e64 years without overt CVD, participating in the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention programme during the period 2009e2016. Lipidograms of 92,373 adults (58.4% women and 41.6% men) included in the database were analysed and screening for SH was performed. Results: The mean levels of total cholesterol, LDL cholesterol (LDL-C) and triglycerides (TG) among participants were 6.08 mmol/l, 3.87 mmol/l, and 1.59 mmol/l, respectively. Any type of dyslipidaemia was present in 89.7%, and severe dyslipidaemia in 13.4% of the study population. 80.2% of adults without overt CVD had LDL-C 3 mmol/l. SH (LDL-C 6 mmol/l) was detected in 3.2% of study participants. Prevalence of SH decreased from 2.91% to 2.82% during the period 2009e2016 (p for trend ¼ 0.003). LDL-C 6.5 mmol/l was observed in 1.5% of subjects while both LDL-C 6.5 mmol/l, and TG  1.7 mmol/l was found in 0.6% of subjects. Conclusions: SH was present in 3.2% of the middle-aged population without overt CVD. Slightly decreasing prevalence of SH was observed during the period 2009e2016 in Lithuania. Likely phenotypic familial hypercholesterolaemia was observed in 1.5% of middle-aged Lithuanians. Further clinical and genetic evaluation of people with SH is needed to detect familial forms of SH. © 2018 Elsevier B.V. All rights reserved. 1. Introduction Various genetic, pathology, observational and intervention studies have established the important role of dyslipidaemia in the development of cardiovascular disease (CVD) [1]. Dyslipidaemia is a multifactorial disorder as an interplay between genetic, lifestyle and environmental factors [2]. It may have different manifestations in certain groups of patients [3]. Proper treatment of dyslipidaemia has been shown to reduce CVD risk by 30% in a 5-year period [4]. Dyslipidaemia remains poorly controlled and is a very prevalent risk factor in Lithuania through the years, whereas variations in the characteristics of individual lipidogram parameters have been observed [5]. Dyslipidaemias cover a broad spectrum of lipid dis- orders and a high proportion of patients have complex lipid abnormalities. * Corresponding author. Vilnius University Hospital Santaros Klinikos, Santariskiu str. 2, 08661, Vilnius, Lithuania. E-mail address: sandra.kutkiene@santa.lt (S. Kutkiene). Contents lists available at ScienceDirect Atherosclerosis journal homepage: www.elsevier.com/locate/atherosclerosis https://doi.org/10.1016/j.atherosclerosis.2018.06.008 0021-9150/© 2018 Elsevier B.V. All rights reserved. Atherosclerosis 277 (2018) 267e272