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

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.