Sex differences in hypercholesterolemia management (2002−2022): evidence from the Swiss National Health Surveys

TL;DR

This study finds that women in Switzerland are less likely to be diagnosed and treated for high cholesterol than men, with differences varying by age over two decades.

Contribution

The study reveals persistent sex disparities in hypercholesterolemia management in Switzerland, even with universal healthcare.

Findings

Women were consistently less likely to be diagnosed with hypercholesterolemia compared to men.

Treatment rates for diagnosed women were lower than for men, with no improvement over time.

Older women showed undertreatment despite a healthcare system that is universally accessible.

Abstract

To investigate sex differences in hypercholesterolemia management (screening, diagnosis, treatment, control) in Switzerland (2002–2022); secondarily, to examine whether these disparities changed over time and varied by age.

Data from five nationally representative Swiss Health Surveys were used (n = 72,804; 53.9 % female). Multivariable logistic regressions were adjusted for demographic, socioeconomic, and lifestyle covariates. Age-stratified analyses used >50 years as a proxy for menopause.

After multivariable adjustment, no significant sex differences in screening were observed except in 2022. Across all survey years, females were consistently less likely to be diagnosed with hypercholesterolemia (e.g., OR 0.66, 95 % CI 0.61, 0.70 in 2022) or to be treated once diagnosed (e.g., OR 0.77, 95 % CI 0.68, 0.88 in 2022), with no evidence of narrowing over time. Among treated participants, cholesterol control was initially higher in females (2002–2007) but showed no sex difference by 2022. Age-stratified analyses indicated that the magnitude and direction of sex disparities varied by age.

This study indicates age-specific sex differences across all stages of self-reported hypercholesterolemia management in Switzerland over two decades.

•Analyzed 20 years of national survey data on hypercholesterolemia management.•Identified sex gaps in screening, diagnosis, treatment, and control.•Used age > 50 as a menopause proxy to examine age-specific disparities.•Results showed undertreatment of older females despite universal healthcare.

Analyzed 20 years of national survey data on hypercholesterolemia management.

Identified sex gaps in screening, diagnosis, treatment, and control.

Used age > 50 as a menopause proxy to examine age-specific disparities.

Results showed undertreatment of older females despite universal healthcare.