Factors Associated with High Blood Cholesterol among Indigenous Adults in Canada: A Cross-sectional Analysis of the 2022 Canadian Community Health Survey

Abstract

Background: High blood cholesterol is a major modifiable risk factor for cardiovascular disease, but evidence on associated factors among Indigenous adults in Canada remains limited. Objective: To identify demographic, socioeconomic, lifestyle, and clinical factors associated with high blood cholesterol among Indigenous adults in Canada. Methods: A cross-sectional study was conducted using data from the 2022 Canadian Community Health Survey. The analysis included 1,632 Indigenous adults aged ≥18 years, representing 607,893 adults after survey weighting. Survey-weighted multivariable logistic regression with bootstrap replicate weights estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for self-reported high blood cholesterol. Results: Older age, diabetes, hypertension, and province of residence were independently associated with high blood cholesterol. Compared with adults aged 18–34 years, higher odds were observed among those aged 50–64 years (aOR=5.16, 95% CI 1.88–14.16) and ≥65 years (aOR=5.80, 95% CI 2.05–16.42). Diabetes (aOR=7.06, 95% CI 2.77–17.99) and hypertension (aOR=2.36, 95% CI 1.18–4.70) were also associated with higher odds. Compared with Atlantic Canada, lower odds were observed in Quebec (aOR=0.25, 95% CI 0.07–0.98) and the Prairies (aOR=0.28, 95% CI 0.10–0.81). Sex, education, body mass index, smoking, and alcohol consumption were not significantly associated with the outcome. Conclusions: Older age, diabetes, hypertension, and geographic region were associated with high blood cholesterol among Indigenous adults in Canada. These findings support integrated cardiovascular risk assessment and early identification of dyslipidaemia in Indigenous populations.