Factors associated with raised total blood cholesterol among people aged 18 to 69 years: a secondary data analysis using Rwanda STEPS survey 2022

The rise in total cholesterol level is a public health concern globally, with implications for cardiovascular health especially in developing countries. The prevalence of raised total cholesterol in Rwanda was 2.9% in 2017, increased to 5.6% for men and 7.4% in women in the 55–64 year age groups. A secondary analysis of data collected from a national population-based survey conducted to identify the factors associated with raised total blood cholesterol. This research utilized a sample of 6000 participants, drawn from the STEPS (STEPS-wise Approach to Surveillance) survey. Descriptive analysis was used to summarize the respondents characteristics, Bivariate analysis was conducted using weighted Pearson’s chi-square test to examine the association between each independent variable (Normal or raised total blood cholesterol). A significance threshold of p < 0.05 was used to identify variables for inclusion in the weighted multivariable model. This study found that the prevalence of raised total blood cholesterol among Rwandan adults aged 18 to 69 years showed notable differences by age and gender. Overall, women had a higher prevalence (3.3%) of raised cholesterol compared to men (2.1%). The analysis for the association between lifestyle and health status factors with raised total blood cholesterol among participants was analyzed and revealed a significant association between WHO recommended amount of fruits and vegetables and raised total blood cholesterol p < 0.001. After adjusting for potential confounders, multivariate analysis confirmed significant associations. Body Mass Index (BMI) remained a strong predictor; the odds of raised total blood cholesterol were 2.9 times higher among overweight and obese participants than those with normal BMI (AOR = 2.9, 95% CI = 1.72–5.01, p < 0.001). This study highlights the varied effects nature of raised total blood cholesterol among Rwandan adults aged 18 to 69. Urban residence, older age, female sex, and higher body mass index (BMI) emerged as significant contributors to raised total cholesterol.