dyslipidemia – epidemiology forecast to 2023 · dyslipidemia – epidemiology forecast to 2023...

REFERENCE CODE GDHCER004-14 | PUBLICAT ION DATE OCTOBER 2014

DYSLIPIDEMIA – EPIDEMIOLOGY FORECAST TO 2023

Dyslipidemia – Epidemiology Forecast to 2023 2 © GlobalData. This report is a licensed product and is not to be copied, reproduced, shared or resold in any form.


Executive Summary

Dyslipidemia is a condition in which one or more of

the serum lipid levels are abnormal. It is a well-

established risk factor for cardiovascular disease,

and the burden of morbidity, mortality, and medical

costs arising from dyslipidemia is substantial

(WHO, 2002). This report provides an overview of

the risk factors, comorbidities, and global trends for

dyslipidemia in the eight major markets (8MM)

(US, France, Germany, Italy, Spain, UK, Japan,

and China [urban]). It includes a 10-year

epidemiological forecast for the total prevalent

cases of dyslipidemia (defined as: elevated low-

density lipoprotein cholesterol [LDLc], high

triglycerides [TG] [≥200mg/dL], or low levels of

high-density lipoprotein cholesterol [HDLc]), as well

as the total prevalent cases of increased LDLc

(≥115mg/dL to ≥160mg/dL based on country-

specific cut-offs), and very high TG (≥500mg/dL),

segmented by sex and age (in 10-year intervals

beginning at 20 years and ending at ≥70 years).

Additionally, the forecast provides the total

prevalent cases of familial hypercholesterolemia

(FH) in these markets.

To build the epidemiological forecast for the total

prevalent cases of dyslipidemia in the 8MM,

GlobalData epidemiologists used nationally

representative studies that provided the total

prevalence of serum lipid disturbances (LDLc, TG,

and HDLc) using the National Cholesterol

Education Program (NCEP) guidelines for the

detection, evaluation, and treatment of high blood

cholesterol in adults (part of the Adult Treatment

Panel III [ATP III]) shown in Table 3 (NIH, 2002).

To build the epidemiological forecast for the total

prevalent cases of FH in the 8MM, GlobalData

epidemiologists selected the best available studies

from peer reviewed journals that provided the total

prevalence of FH using the Simon Broome

Classification criteria shown in Table 4, or the

LDLc based criteria shown in Table 5. The forecast

methodology is consistent across the 8MM,

thereby allowing for a meaningful forecast

comparison of the total prevalent cases of

dyslipidemia as well as the total prevalent cases of

FH in these markets.

Below Figure presents the total prevalent cases of

dyslipidemia in the 8MM for 2013 and 2023.

GlobalData epidemiologists forecast that the total

prevalent cases of dyslipidemia in the 8MM will

increase from 572,418,492 total prevalent cases in

2013, to 685,905,635 total prevalent cases in

2023, at an Annual Growth Rate (AGR) of 1.99%.

All markets will see an increase in the total

prevalent cases of dyslipidemia at varying AGRs,

except for Germany, which will see a decrease.


FH in the 8MM for 2013 and 2023. The 8MM had

an estimated 3,339,447 total prevalent cases of FH

in 2013, and the number of total prevalent cases is

expected to increase to 4,365,831 by 2023, at an

AGR of 3.07%. All markets will see an increase in

the total prevalent cases of FH at varying AGRs,

except for Japan, which will see a decrease.



Executive Summary


increased LDLc (≥115mg/dL to ≥160mg/dL based

on country-specific cut-offs) in the 8MM for 2013

and 2023. GlobalData epidemiologists forecast that

the total prevalent cases of increased LDLc in the

8MM will increase from 345,008,543 total prevalent

cases in 2013 to 411,737,455 total prevalent cases

in 2023, at an AGR of 1.93%. All markets will see

an increase in the total prevalent cases of

increased LDLc at varying AGRs, except for

Germany, which will see a decrease. Below Figure

presents the total prevalent cases of very high TG

(≥500mg/dL) in the 8MM for 2013 and 2023. The

8MM had an estimated 10,777,756 total prevalent

cases of very high TG in 2013, and the number of

total prevalent cases is expected to increase to

12,746,492 by 2023, at an AGR of 1.83%. All

markets will see an increase in the total prevalent

cases of very high TG at varying AGRs, except for

Germany and Japan, which will see a decrease.

8MM, Total Prevalent Cases of Dyslipidemia, Both Sexes, Ages ≥20 Years, N, 2013 and 2023

18,396,745

25,164,099

27,165,228

28,093,665

38,492,353

40,264,608

139,084,345

145,681,447362,647,490

685,905,635

17,410,727

24,102,031

27,444,219

26,040,545

37,458,800

39,282,355

134,279,877

133,487,408

266,922,407

572,148,492

0.00 200,000,000 400,000,000 600,000,000 800,000,000

UK

France

Germany

Spain

Japan

Italy

5EU

US

China (urban)

8MM

Total Prevalent Cases of Dyslipidemia (N)

Mar

kets

20132023

Source: GlobalData; Ali et al., 2006; Aresu et al., 2008; Ervin, 2009; Ferrières et al., 2009; Grau et al., 2007; Miller et al., 2011; Moebus et al., 2008; NMC Ospedalieri, 2004; Scheidt-Nave et al., 2013; Suka et al., 2013; Urashima et al., 2005; Wittchen et al., 2005; Yan et al., 2012 5EU = France, Germany, Italy, Spain, and UK; 8MM = US, 5EU, Japan, and China (urban)

8MM, Total Prevalent Cases of Familial Hypercholesterolemia, Both Sexes, Ages ≥20 Years, N, 2013 and 2023

114,191

129,417

156,696

161,202

163,274

209,414

780,683

820,003

2,650,954

4,365,831

114,532

112,476

146,000

150,937

153,889

208,871

700,096

772,173

1,752,646

3,339,447

0.00 1,000,000 2,000,000 3,000,000 4,000,000 5,000,000

JapanSpain

UKFrance

ItalyGermany

US5EU

China (urban)8MM

Total Prevalent Cases of Familial Hypercholesterolemia (N)

Mar

kets

20132023

Source: GlobalData; Mabuchi et al., 1977; Neil et al., 2000; Shi et al., 2014; Vishwanath and Hemphill, 2014 5EU = France, Germany, Italy, Spain, and UK; 8MM = US, 5EU, Japan, and China (urban)



Executive Summary

8MM, Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Both Sexes, Ages ≥20 Years, N, 2013 and 2023

16,023,257

18,963,569

20,457,693

20,569,890

31,524,694

31,583,442

81,103,443

107,539,103

191,511,467

411,737,455

15,213,253

18,150,658

18,992,488

20,822,308

30,789,887

30,380,124

74,167,476

103,968,594

136,492,349

345,008,543

0.00 100,000,000 200,000,000 300,000,000 400,000,000 500,000,000

UK

France

Spain

Germany

Italy

Japan

US

5EU

China (urban)8MM

Total Prevalent Caes of Increased LDLc (≥115mg/dL to ≥160mg/dL)* (N)

Mar

kets 2013

2023

Source: GlobalData; Ferrières et al., 2009; Grau et al., 2007; NMC Ospedalieri, 2004; Roger et al., 2012; Suka et al., 2013; Wittchen et al., 2005; Yan et al., 2012 *Increased LDLc based on country-specific cut-offs, which range from ≥115mg/dL to ≥160mg/dL. 5EU = France, Germany, Italy, Spain, and UK; 8MM = US, 5EU, Japan, and China (urban)

8MM, Total Prevalent Cases of Very High TG (≥500mg/dL), Both Sexes, Ages ≥20 Years, N, 2013 and 2023

293,068

338,441

360,097

457,251

459,435

653,547

1,908,292

2,787,355

7,397,298

12,746,492

262,502

332,098

348,579

479,919

445,257

659,103

1,868,355

2,662,2835,588,015

10,777,756

0.00 5,000,000 10,000,000 15,000,000

SpainFrance

UKGermany

ItalyJapan

5EUUS

China (urban)8MM

Total Prevalent Cases of Very High TG (≥500mg/dL)

Mar

kets 2013

2023

Source: GlobalData; Ferrières et al., 2009; Grau et al., 2007; Miller et al., 2011; Moebus et al., 2008; NMC Ospedalieri, 2004; Urashima et al., 2005; Yan et al., 2012 5EU = France, Germany, Italy, Spain, and UK; 8MM = US, 5EU, Japan, and China (urban)


Table of Contents


1 Table of Contents

1 Table of Contents ....................................................................................................................... 5

1.1 List of Tables ...................................................................................................................... 7

1.2 List of Figures ..................................................................................................................... 9

2 Introduction ............................................................................................................................... 10

2.1 Catalyst ............................................................................................................................. 10

2.2 Related Reports ................................................................................................................ 11

2.3 Upcoming Related Reports ............................................................................................... 12

3 Epidemiology ............................................................................................................................ 13

3.1 Disease Background ......................................................................................................... 13

3.2 Risk Factors and Comorbidities ........................................................................................ 14

3.3 Global Trends ................................................................................................................... 15

3.3.1 US ................................................................................................................................. 16

3.3.2 5EU ............................................................................................................................... 16

3.3.3 Asia ............................................................................................................................... 18

3.4 Forecast Methodology ....................................................................................................... 19

3.4.1 Sources Used................................................................................................................ 27

3.4.2 Sources Not Used ......................................................................................................... 33

3.4.3 Forecast Assumptions and Methods ............................................................................. 34

3.5 Epidemiological Forecast for Dyslipidemia (2013–2023) ................................................... 60

3.5.1 Total Prevalent Cases of Dyslipidemia .......................................................................... 60

3.5.2 Age-Specific Total Prevalent Cases of Dyslipidemia ..................................................... 62


Table of Contents


3.5.3 Sex-Specific Total Prevalent Cases of Dyslipidemia ...................................................... 63

3.5.4 Age-Standardized Total Prevalence of Dyslipidemia ..................................................... 65

3.6 Epidemiological Forecast for Familial Hypercholesterolemia (2013–2023) ........................ 66

3.6.1 Total Prevalent Cases of Familial Hypercholesterolemia ............................................... 66

3.7 Epidemiological Forecast for Increased LDLc (2013–2023) .............................................. 67

3.7.1 Total Prevalent Cases of Increased LDLc ..................................................................... 67

3.7.2 Age-Specific Total Prevalent Cases of Increased LDLc ................................................. 69

3.7.3 Sex-Specific Total Prevalent Cases of Increased LDLc ................................................. 72

3.7.4 Age-Standardized Total Prevalence of Increased LDLc ................................................ 73

3.8 Epidemiological Forecast for Very High TG (≥500mg/dL) (2013–2023) ............................. 74

3.8.1 Total Prevalent Cases of Very High TG (≥500mg/dL) .................................................... 74

3.8.2 Age-Specific Total Prevalent Cases of Very High TG (≥500mg/dL) ............................... 76

3.8.3 Sex-Specific Total Prevalent Cases of Very High TG (≥500mg/dL) ............................... 77

3.8.4 Age-Standardized Total Prevalence of Very High TG (≥500mg/dL) ............................... 79

3.9 Discussion ........................................................................................................................ 79

3.9.1 Epidemiological Forecast Insight ................................................................................... 79

3.9.2 Limitations of the Analysis ............................................................................................. 81

3.9.3 Strengths of the Analysis ............................................................................................... 82

4 Appendix................................................................................................................................... 83

4.1 Bibliography ...................................................................................................................... 83

4.2 About the Authors ............................................................................................................. 89

4.2.1 Epidemiologists ............................................................................................................. 89

4.2.2 Reviewers ..................................................................................................................... 89


Table of Contents


4.2.3 Acting Director of Epidemiology..................................................................................... 90

4.2.4 Global Head of Healthcare ............................................................................................ 91

4.3 About GlobalData .............................................................................................................. 92

4.4 About EpiCast ................................................................................................................... 92

4.5 Disclaimer ......................................................................................................................... 93

1.1 List of Tables

Table 1: Risk Factors and Comorbidities for Dyslipidemia ......................................................................... 15

Table 2: Overview of the Total Prevalence of Low HDLc in the 5EU .......................................................... 18

Table 3: NCEP-ATP III Classification of LDLc, TG, and HDLc ................................................................... 20

Table 4: Simon Broome Diagnostic Criteria for FH .................................................................................... 21

Table 5: LDLc Based Definition of FH ....................................................................................................... 21

Table 6: Sources of Total Prevalence Data for FH in the 8MM ................................................................... 22

Table 7: Sources of Total Prevalence Data for Increased LDLc in the 8MM ............................................... 23

Table 8: Sources of Total Prevalence Data for High TG (≥200mg/dL) in the 8MM ...................................... 24

Table 9: Sources of Total Prevalence Data for Very High TG (≥500mg/dL) in the 8MM .............................. 25

Table 10: Sources of Total Prevalence Data for Low HDLc in the 8MM ....................................................... 26

Table 11: 8MM, Sources Not Used in the Epidemiological Analysis of Dyslipidemia .................................... 34

Table 12: 8MM, Total Prevalent Cases of Dyslipidemia, Both Sexes, Ages ≥20 Years, N, 2013–2023 ......... 61

Table 13: 8MM, Age-Specific Total Prevalent Cases of Dyslipidemia, Both Sexes, N (Row %), 2013 .......... 62

Table 14: 8MM, Sex-Specific Total Prevalent Cases of Dyslipidemia, Ages ≥20 Years, N (Row %), 2013 .... 64

Table 15: 8MM, Total Prevalent Cases of Familial Hypercholesterolemia, Both Sexes, Ages ≥20 Years, N,

2013–2023 .................................................................................................................................. 66


Table of Contents


Table 16: 8MM, Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Both Sexes, Ages

≥20 Years, N, 2013–2023 ............................................................................................................ 68

Table 17: 8MM, Age-Specific Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Both

Sexes, N (Row %), 2013 ............................................................................................................. 70

Table 18: 8MM, Sex-Specific Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Ages

≥20 Years, N (Row %), 2013 ....................................................................................................... 72

Table 19: 8MM, Total Prevalent Cases of Very High TG (≥500mg/dL), Both Sexes, Ages ≥20 Years, N,

2013–2023 .................................................................................................................................. 75

Table 20: 8MM, Age-Specific Total Prevalent Cases of Very High TG (≥500mg/dL), Both Sexes, N (Row %),

2013............................................................................................................................................ 76

Table 21: 8MM, Sex-Specific Total Prevalent Cases of Very High TG (≥500mg/dL), Ages ≥20 Years, N (Row

%), 2013 ..................................................................................................................................... 78


Table of Contents


1.2 List of Figures

Figure 1: 8MM, Total Prevalent Cases of Dyslipidemia, Both Sexes, Ages ≥20 Years, N, 2013–2023 ......... 61

Figure 2: 8MM, Age-Specific Total Prevalent Cases of Dyslipidemia, Both Sexes, Ages ≥20 Years, N, 2013

................................................................................................................................................... 63

Figure 3: 8MM, Sex-Specific Total Prevalent Cases of Dyslipidemia, Ages ≥20 Years, N, 2013 .................. 64

Figure 4: 8MM, Age-Standardized Total Prevalence of Dyslipidemia (%), Ages ≥20 Years, by Sex, 2013 ... 65

Figure 5: 8MM, Total Prevalent Cases of Familial Hypercholesterolemia, Both Sexes, Ages ≥20 Years, N,

2013–2023 .................................................................................................................................. 67

Figure 6: 8MM, Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Both Sexes, Ages

≥20 Years, N, 2013–2023 ............................................................................................................ 68

Figure 7: 8MM, Age-Specific Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Both

Sexes, Ages ≥20 Years, N, 2013 ................................................................................................. 71

Figure 8: 8MM, Sex-Specific Total Prevalent Cases of Increased LDLc* (≥115mg/dL to ≥160mg/dL), Ages

≥20 Years, N, 2013 ..................................................................................................................... 73

Figure 9: 8MM, Age-Standardized Total Prevalence of Increased LDLc (≥115mg/dL to ≥160mg/dL)* (%),

Ages ≥20 Years, by Sex, 2013 .................................................................................................... 74

Figure 10: 8MM, Total Prevalent Cases of Very High TG (≥500mg/dL), Both Sexes, Ages ≥20 Years, N,

2013–2023 .................................................................................................................................. 75

Figure 11: 8MM, Age-Specific Total Prevalent Cases of Very High TG (≥500mg/dL), Both Sexes, Ages ≥20

Years, N, 2013 ............................................................................................................................ 77

Figure 12: 8MM, Sex-Specific Total Prevalent Cases of Very High TG (≥500mg/dL), Ages ≥20 Years, N, 2013

................................................................................................................................................... 78

Figure 13: 8MM, Age-Standardized Total Prevalence of Very High TG (≥500mg/dL) (%), Ages ≥20 Years, by

Sex, 2013 .................................................................................................................................... 79



Introduction

2 Introduction

2.1 Catalyst

Dyslipidemia is a condition in which one or more of the serum lipid levels are abnormal. It is a well-

established risk factor for cardiovascular disease, and the burden of morbidity, mortality, and

medical costs arising from dyslipidemia is substantial (WHO, 2002).

This report provides an overview of the risk factors, comorbidities, and global trends for

dyslipidemia in the eight major markets (8MM) (US, France, Germany, Italy, Spain, UK, Japan,

and China [urban]). It includes a 10-year epidemiological forecast for the total prevalent cases

of dyslipidemia (defined as: increased low-density lipoprotein cholesterol [LDLc], high

triglycerides [TG] [≥200mg/dL], or low levels of high-density lipoprotein cholesterol [HDLc]), as

well as the total prevalent cases of increased LDLc (≥115mg/dL to ≥160mg/dL based on

country-specific cut-offs), and very high TG (≥500mg/dL), segmented by sex and age (in 10-

year intervals beginning at 20 years and ending at ≥70 years). Additionally, the forecast

provides the total prevalent cases of familial hypercholesterolemia (FH) in these markets.

GlobalData epidemiologists forecast that the total prevalent cases of dyslipidemia in the 8MM

will increase from 572,418,492 total prevalent cases in 2013, to 685,905,635 total prevalent

cases in 2023, at an Annual Growth Rate (AGR) of 1.99%. All markets will see an increase in

the total prevalent cases of dyslipidemia at varying AGRs, except for Germany, which will see

a decrease.

The 8MM had an estimated 3,339,447 total prevalent cases of FH in 2013, and the number of

total prevalent cases of FH is expected to increase to 4,365,831 by 2023, at an AGR of 3.07%.

All markets will see an increase in the total prevalent cases of FH at varying AGRs, except for

Japan, which will see a decrease.

GlobalData epidemiologists forecast that the total prevalent cases of increased LDLc in the

8MM will increase from 345,008,543 total prevalent cases in 2013 to 411,737,455 total

prevalent cases in 2023, at an AGR of 1.93%. All markets will see an increase in the total

prevalent cases of increased LDLc at varying AGRs, except for Germany, which will see a

decrease.



Introduction

The 8MM had an estimated 10,777,756 total prevalent cases of very high TG (≥500mg/dL) in

2013, and the number of total prevalent cases of very high TG is expected to increase to

12,746,492 by 2023, at an AGR of 1.83%. All markets will see an increase in the total prevalent

cases of very high TG at varying AGRs, except for Germany and Japan, which will see a

decrease.

The two biggest factors that may impact the prevalence of dyslipidemia, increased LDLc, and

very high TG (≥500mg/dL) during the next decade may be: changes in the prevalence of risk

factors for these serum lipid abnormalities, and changes in the intensity with which healthcare

professionals in different markets may be focused on the identification and correction of serum

lipid abnormalities as a means of reducing cardiovascular risk.

2.2 Related Reports

GlobalData (2014). PharmaPoint: Dyslipidemia – Global Drug Forecast and Market Analysis to

2023, October 2014, GDHC110PIDR

EpiCast Report: Acute Coronary Syndrome (ACS) – Epidemiology Forecast to 2023, July

2014, GDHCER053-14

GlobalData (2014). PharmaPoint: Acute Coronary Syndrome – Global Drug Forecast and

Market Analysis to 2023, July 2014, GDHC69PIDR

GlobalData (2013). EpiCast Report: Overweight and Obesity – Epidemiology Forecast to 2022,

August 2013, GDHCER022-13

GlobalData (2013). PharmaPoint: Obesity – Global Drug Forecast and Market Analysis to

2022, October 2013, GDHC50PIDR

GlobalData (2013). EpiCast Report: Acute Ischemic Stroke – Epidemiology Forecast to 2022,

September 2013, GDHCER028-13

GlobalData (2013). PharmaPoint: Acute Ischemic Stroke – Opportunity Analysis and Forecast

to 2017, December 2013, GDHC013POA



Introduction

GlobalData (2013). EpiCast Report: Type 2 Diabetes – Epidemiology Forecast to 2022, June

2013, GDHCER023-13

GlobalData (2013). PharmaPoint: Type 2 Diabetes – Global Drug Forecast and Market

Analysis to 2022, July 2013, GDHC55PIDR

2.3 Upcoming Related Reports

GlobalData (2014). EpiCast Report: Type 1 Diabetes – Epidemiology Forecast to 2023,

November 2013, GDHCER080-14

GlobalData (2014). PharmaPoint: Type 1 Diabetes – Global Drug Forecast and Market

Analysis to 2023, GDHC105PIDR



Appendix

4.3 About GlobalData

GlobalData is a leading global provider of business intelligence in the healthcare industry.

GlobalData provides its clients with up-to-date information and analysis on the latest developments

in drug research, disease analysis, and clinical research and development. Our integrated business

intelligence solutions include a range of interactive online databases, analytical tools, reports, and

forecasts. Our analysis is supported by a 24/7 client support and analyst team.

GlobalData has offices in New York, San Francisco, Boston, London, India, Korea, Japan,

Singapore, and Australia.

4.4 About EpiCast

EpiCast is a series of premier epidemiology reports written and developed by Master’s-

and PhD-level epidemiologists.

EpiCast Reports are in-depth, high quality, transparent, and market-driven, providing expert

analysis of epidemiological trends and forecasting of patient populations for major markets.

Specifically, the reports identify disease trends over a 10-year forecast period in six to seven major

markets (US, France, Germany, Italy, Spain, UK, and Japan). Additional countries, such as

Canada, Brazil, China, and India, are covered in these reports if their markets are highly relevant.



Appendix

4.5 Disclaimer

All Rights Reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any

form by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior

permission of the publisher, GlobalData.

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